Dose optimization of tyrosine kinase inhibitors to improve outcomes in GIST

摘要: Tyrosine kinase inhibitors such as imatinib and sunitinib have greatly improved clinical outcomes for patients with gastrointestinal stromal tumors (GIST). Dose optimization of these agents is critical involves multiple considerations, including ensuring a durable response, monitoring drug blood levels to confirm adequate dosing, deciding whether use high-dose or switch second-line in the event disease progression appropriately managing treatment-associated side effects. Imatinib standard first-line therapy unresectable metastatic GIST also an option adjuvant treatment resected disease. Despite efficacy safety advanced GIST, some individuals develop primary secondary resistance intolerance drug. For disease, dose escalation 800 mg/day warranted cases on 400 mg/day. In addition, documented KIT exon 9 mutations are likely derive benefit from initial improve outcomes. who fail imatinib, effective option. However, decision either should be based underlying cause failure mutational status patient intolerant has developed imatinib. this article we review existing literature supporting provide current perspective how best management optimize