Treatment dilemmas in patients with gastrointestinal stromal tumors (GIST) who experienced imatinib-induced pneumonitis: A case series

Autor: Deborah van de Wal, Evelyne Roets, Roos F. Bleckman, Jorn Nützinger, Birthe C. Heeres, J. Martijn Kerst, Mahmoud Mohammadi, Anna K.L. Reyners, Ingrid M.E. Desar, Astrid W. Oosten, Neeltje Steeghs, Winette T.A. van der Graaf
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Current Problems in Cancer: Case Reports, Vol 13, Iss , Pp 100280- (2024)
Druh dokumentu: article
ISSN: 2666-6219
DOI: 10.1016/j.cpccr.2024.100280
Popis: Introduction: Imatinib has led to a phenomenal progress in the treatment of GIST. A rare and lesser-known side effect of imatinib is pneumonitis, an uncommon multicausal interstitial lung disease. Methods: Patients registered within the Dutch GIST Registry (DGR) were reviewed. For the patients identified with an imatinib-induced pneumonitis we reported the time on imatinib to develop pneumonitis, how the pneumonitis was diagnosed, graded and managed, and how the GIST treatment was managed. Cases: Of the 1934 patients registered in the DGR, 1161 patients received imatinib at some point, of which nine patients (0.8 %) were identified with an imatinib-induced pneumonitis. At time of the pneumonitis, patients received a daily imatinib dose of 200–400 mg for a mean duration of 486 days. One patient was able to continue imatinib in a lower dose, in the other eight patients imatinib was interrupted, and six of these patients started prednisolone treatment. After management of the imatinib-induced pneumonitis, four patients stopped imatinib permanently, two patients were rechallenged with imatinib, and two patients started treatment with second-line sunitinib. Conclusion: Imatinib-induced pneumonitis is a rare side effect, which may affect GIST management considerably. After the management of imatinib-induced pneumonitis, clinicians are left with difficult treatment dilemmas.
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