A long-term control of gastrointestinal stromal tumor with sunitinib

The patient was a 70-year-old woman with gastrointestinal stromal tumor (GIST) of the small intestine, accompanied by liver metastasis. Multiple liver metastases were pointed out 3 months after R0 surgery (jejunectomy and hepatectomy). Although she was given radiofrequency ablation (RFA) therapy and imatinib, metastatic tumors progressed. In a further examination at our institution 21 months after R0 surgery, multiple liver, bone, and lung metastases were indicated, and she was given sunitinib once daily at a 50 mg in 6-week courses, with 4 weeks on and 2 weeks off treatment. Although sunitinib dosage was decreased to 25 mg/day because of adverse events, 21 courses of this treatment were administrered, and it took 137 weeks to progress her disease with this sunitinib treatment. At our institution, seven cases of GIST were treated with sunitinib, and the median time to progression was 30-weeks. That was almost the same result as for Japan and international clinical trials. Sunitinb treatment may be one of the most important therapeutic options for unresectable imatinib-resistant GIST.