Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor

Wei Lien Wang, Anthony Conley, David Reynoso, Laura Nolden, Alexander J. Lazar, Suzanne George, Jonathan Trent

Research output: Contribution to journalArticle

51 Citations (Scopus)

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 languageEnglish
JournalCancer Chemotherapy and Pharmacology
Volume67
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Fingerprint

Gastrointestinal Stromal Tumors
Tumors
Mutation
Exons
Phosphotransferases
Genes
Platelet-Derived Growth Factor Receptors
Codon
Sarcoma
Gastrointestinal Tract
Imatinib Mesylate
sunitinib
Neoplasms
Adenosine Triphosphate

Keywords

  • Gene mutations
  • GIST
  • Imatinib-resistant disease
  • Mutated KIT

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology

Cite this

Wang, W. L., Conley, A., Reynoso, D., Nolden, L., Lazar, A. J., George, S., & Trent, J. (2011). Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor. Cancer Chemotherapy and Pharmacology, 67(SUPPL. 1). https://doi.org/10.1007/s00280-010-1513-8

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.

In: Cancer Chemotherapy and Pharmacology, Vol. 67, No. SUPPL. 1, 01.01.2011.

Research output: Contribution to journalArticle

Wang, WL, Conley, A, Reynoso, D, Nolden, L, Lazar, AJ, George, S & Trent, J 2011, 'Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor', Cancer Chemotherapy and Pharmacology, vol. 67, no. SUPPL. 1. https://doi.org/10.1007/s00280-010-1513-8
Wang, Wei Lien ; Conley, Anthony ; Reynoso, David ; Nolden, Laura ; Lazar, Alexander J. ; George, Suzanne ; Trent, Jonathan. / Mechanisms of resistance to imatinib and sunitinib in gastrointestinal stromal tumor. In: Cancer Chemotherapy and Pharmacology. 2011 ; Vol. 67, No. SUPPL. 1.
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