Mechanisms of resistance to imatinib mesylate in gastrointestinal stromal tumors and activity of the PKC412 inhibitor against imatinib-resistant mutants

作者: Maria Debiec-Rychter , Jan Cools , Herlinde Dumez , Raf Sciot , Michel Stul

DOI: 10.1053/J.GASTRO.2004.11.020

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摘要: Background & Aims: Resistance is a major challenge in the treatment of patients with gastrointestinal stromal tumors (GISTs). We investigated mechanisms resistance progressive GISTs primary KIT mutations and efficacy kinase inhibitor PKC412 for inhibition imatinib-resistant mutants. Methods: performed cytogenetic analysis screened PDGFRA domains 26 resistant GISTs. autophosphorylation status was assessed by Western immunoblotting. Imatinib-resistant GIST cells Ba/F3 expressing these mutant proteins were tested sensitivity to imatinib PKC412. Results: Six distinct secondary detected 12 tumors, V654A T670I found be recurrent. One tumor showed acquired PDGFRA-D842V mutation. Amplification or KIT/PDGFRA 2 patients. Eight 10 available phosphorylated KIT. Two remaining lost protein expression. carrying KIT-del557-558/T670I KIT-InsAY502-503/V654A imatinib, while significantly inhibited autophosporylation KIT-T670I mutants confirmed using cells. Conclusions: This study shows high frequency domain defines genomic amplification as an alternative cause drug. In subset patients, cancer their dependence on targeted tyrosine kinase. Our findings show KIT-V654A

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