Premium
Liver transplantation for metastatic wild‐type gastrointestinal stromal tumor in the era of molecular targeted therapies: Report of a first case
Author(s) -
Iesari Samuele,
Mocchegiani Federico,
Nicolini Daniele,
Benedetti Cacciaguerra Andrea,
Coletta Martina,
Montalti Roberto,
Mandolesi Alessandra,
Lerut Jan,
Vivarelli Marco
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15377
Subject(s) - medicine , gist , imatinib , liver transplantation , stromal tumor , everolimus , sunitinib , tyrosine kinase , transplantation , tyrosine kinase inhibitor , targeted therapy , immunosuppression , hepatectomy , cancer research , oncology , pathology , stromal cell , gastroenterology , surgery , cancer , receptor , resection , myeloid leukemia
The gastrointestinal stromal tumor ( GIST ) is a digestive neoplasm of mesenchymal lineage. The treatment strategy for receptor tyrosine kinase‐mutated GIST s is well defined. Wild‐type GIST s ( WT ‐ GIST s) respond unsatisfactorily to specific kinase inhibitors. Moreover, evidence shows that repeat surgery has limited benefit. We report the case of a young female patient who was diagnosed with liver metastatic WT ‐ GIST , after initial radical resection and adjuvant therapy with molecular targeted drugs. Due to the disease progression, a two‐stage surgery was performed, with the removal of extrahepatic lesions followed by a total hepatectomy. The patient is disease‐free after 4 years from liver transplantation ( LT ), performed under everolimus‐based immunosuppression. The treatment of WT ‐ GIST s remains a significant challenge due to the frequent resistance to tyrosine kinase inhibitors ( TKI s). Liver transplantation might represent an effective treatment option for such disease.