Current management of patients with gastrointestinal stromal tumor receiving the multitargeted tyrosine kinase inhibitor sunitinib

Abstract

Background:

Gastrointestinal stromal tumor (GIST), a form of soft tissue sarcoma, is often detected incidentally or at an advanced stage. The tyrosine kinase inhibitor sunitinib malate (Sutent) is established as second-line treatment for the management of GIST after disease progression on, or intolerance to, first-line imatinib treatment. Several published reviews give guidance on management of side effects in patients with advanced renal cell carcinoma treated with sunitinib, but fewer publications cover side-effect management in patients with GIST.

Scope:

Using published articles and abstracts, prescribing information, and personal experience in managing patients with GIST at a specialized center of excellence for cancer care, I review side-effect management recommendations for patients with GIST treated with sunitinib and provide an overview of GIST.

Findings:

Sunitinib has a well described side-effect profile: most side effects occurring in patients with GIST can be easily managed by standard medical intervention and/or dose modification.

Conclusion:

Care of patients with GIST can be enhanced through communication, support, knowledge, and education, with the goal of providing effective therapy and optimal symptom control.

Keywords::

• GIST
• Sarcoma
• Side-effect management
• Sunitinib
• Tyrosine kinase inhibitors

Transparency

Declaration of funding

Editorial assistance for this study was funded by Pfizer. The manuscript was written, the content was controlled, and the decision to submit the paper for publication was made solely by the author, who received no financial support or other compensation related to the development of this paper. Pfizer Inc., the manufacturer of sunitinib and the sponsor of many of the studies described in this manuscript, reviewed the paper for scientific accuracy.

Declaration of financial/other relationships

A.P.P. has disclosed that she has participated in advisory boards for Pfizer, Ariad, and Bayer.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The author acknowledges Dr. George D. Demetri (Dana-Farber Cancer Institute, Boston, MA, USA) for his guidance and support in the development of this manuscript. In particular, I thank Joanne Ryan PhD RN of Pfizer for critical review of the manuscript. Editorial assistance was provided by Cherry Bwalya and Wendy Sacks at Acumed (Tytherington, UK and New York, NY, USA) and was funded by Pfizer Inc.

Notes

*Sutent is a registered trade name of Pfizer Inc., New York, NY, USA