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Sunitinib as first-line neoadjuvant therapy in two patients with rectal stromal tumors
Gan Weidong1, Qu Feng, Sun Xitai
1Department of Urology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Abstract:
In the treatment of rectal stromal tumors, which account for approximately 5% of gastrointestinal stromal tumors, molecular-targeted neoadjuvant therapy should be considered if the tumor is too large to achieve R0 grade resection or multiple visceral resection is required. Currently, imatinib is generally recommended as the first-line agent for such therapy. Although it has been reported that neoadjuvant therapy in patients experiencing imatinib resistance or intolerable adverse events can be successfully achieved by switching to sunitinib, first-line use of sunitinib for neoadjuvant therapy of gastrointestinal stromal tumors has not previously been reported. In this case report, first-line sunitinib neoadjuvant therapy of two patients who had very large rectal stromal tumors at sites close to the prostate and bladder produced good clinical outcomes.
Insights
First-line sunitinib shows promise for neoadjuvant therapy in large rectal gastrointestinal stromal tumors (GISTs). This approach offers a viable alternative when imatinib is unsuitable, achieving good clinical outcomes.
Area of Science:
- Gastrointestinal Oncology
- Molecular Targeted Therapy
- Surgical Oncology
Background:
- Rectal gastrointestinal stromal tumors (GISTs) represent a subset of GISTs requiring specialized treatment strategies.
- Molecular-targeted neoadjuvant therapy is indicated for unresectable or large rectal GISTs.
- Imatinib is the standard first-line neoadjuvant therapy, with sunitinib used for resistance or intolerance.
Observation:
- This case report details the first-line use of sunitinib as neoadjuvant therapy for two patients with very large rectal GISTs.
- The tumors were located in close proximity to the prostate and bladder, posing surgical challenges.
- Patients received sunitinib as initial neoadjuvant treatment.
Findings:
- First-line sunitinib neoadjuvant therapy resulted in good clinical outcomes for both patients.
- This approach demonstrated efficacy in managing large rectal GISTs.
- Successful outcomes were achieved despite tumor location and size.
Implications:
- First-line sunitinib may be a valuable therapeutic option for rectal GISTs when imatinib is not feasible.
- This expands the neoadjuvant treatment landscape for challenging GIST cases.
- Further research is warranted to validate these findings in larger cohorts.
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