Abstract
Gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm of the GI tract and one of the most common sarcomas, is dependent on the expression of the mutated KIT or platelet-derived growth factor receptor in most cases. Imatinib mesylate potently abrogates the effects of KIT signaling by directly binding into the ATP-binding pocket of the kinase. It is becoming increasingly apparent that the binding affinity of imatinib for the receptor is dependent on the type and location of mutation. Within KIT, patients whose tumor has an exon 9 mutation are treated by many clinicians with higher doses of imatinib than those patients with mutations within exon 11. Additionally, there are over 400 unique mutations within exon 11 that may have distinctly different binding affinity for imatinib as well as other kinases. Secondary KIT mutations generally occur at a codon where imatinib binds resulting in KIT reactivation and resistance. Sunitinib malate, a second-generation KIT inhibitor is active in imatinib-resistant disease and is FDA-approved for use in this setting. In this review, we describe the biology of the genes and gene mutations responsible for GIST and discuss known and potential clinical implications.
| Original language | English (US) |
|---|---|
| Journal | Cancer Chemotherapy and Pharmacology |
| Volume | 67 |
| Issue number | SUPPL. 1 |
| DOIs | |
| State | Published - Jan 1 2011 |
| Externally published | Yes |
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Keywords
- Gene mutations
- GIST
- Imatinib-resistant disease
- Mutated KIT
ASJC Scopus subject areas
- Oncology
- Toxicology
- Pharmacology
- Cancer Research
- Pharmacology (medical)
Cite this
Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor. / Wang, Wei Lien; Conley, Anthony; Reynoso, David; Nolden, Laura; Lazar, Alexander J.; George, Suzanne; Trent, Jonathan C.
In: Cancer Chemotherapy and Pharmacology, Vol. 67, No. SUPPL. 1, 01.01.2011.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor
AU - Wang, Wei Lien
AU - Conley, Anthony
AU - Reynoso, David
AU - Nolden, Laura
AU - Lazar, Alexander J.
AU - George, Suzanne
AU - Trent, Jonathan C.
PY - 2011/1/1
Y1 - 2011/1/1
N2 - Gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm of the GI tract and one of the most common sarcomas, is dependent on the expression of the mutated KIT or platelet-derived growth factor receptor in most cases. Imatinib mesylate potently abrogates the effects of KIT signaling by directly binding into the ATP-binding pocket of the kinase. It is becoming increasingly apparent that the binding affinity of imatinib for the receptor is dependent on the type and location of mutation. Within KIT, patients whose tumor has an exon 9 mutation are treated by many clinicians with higher doses of imatinib than those patients with mutations within exon 11. Additionally, there are over 400 unique mutations within exon 11 that may have distinctly different binding affinity for imatinib as well as other kinases. Secondary KIT mutations generally occur at a codon where imatinib binds resulting in KIT reactivation and resistance. Sunitinib malate, a second-generation KIT inhibitor is active in imatinib-resistant disease and is FDA-approved for use in this setting. In this review, we describe the biology of the genes and gene mutations responsible for GIST and discuss known and potential clinical implications.
AB - Gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm of the GI tract and one of the most common sarcomas, is dependent on the expression of the mutated KIT or platelet-derived growth factor receptor in most cases. Imatinib mesylate potently abrogates the effects of KIT signaling by directly binding into the ATP-binding pocket of the kinase. It is becoming increasingly apparent that the binding affinity of imatinib for the receptor is dependent on the type and location of mutation. Within KIT, patients whose tumor has an exon 9 mutation are treated by many clinicians with higher doses of imatinib than those patients with mutations within exon 11. Additionally, there are over 400 unique mutations within exon 11 that may have distinctly different binding affinity for imatinib as well as other kinases. Secondary KIT mutations generally occur at a codon where imatinib binds resulting in KIT reactivation and resistance. Sunitinib malate, a second-generation KIT inhibitor is active in imatinib-resistant disease and is FDA-approved for use in this setting. In this review, we describe the biology of the genes and gene mutations responsible for GIST and discuss known and potential clinical implications.
KW - Gene mutations
KW - GIST
KW - Imatinib-resistant disease
KW - Mutated KIT
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UR - http://www.scopus.com/inward/citedby.url?scp=79151479118&partnerID=8YFLogxK
U2 - 10.1007/s00280-010-1513-8
DO - 10.1007/s00280-010-1513-8
M3 - Article
VL - 67
JO - Cancer Chemotherapy and Pharmacology
JF - Cancer Chemotherapy and Pharmacology
SN - 0344-5704
IS - SUPPL. 1
ER -