Efficacy of regorafenib in gastrointestinal stromal tumors (GISTs) – a case report.

Abstract

The systemic treatment of gastrointestinal stromal tumors is based on targeted therapies such as imatinib, sunitinib, sorafenib or regorafenib. The important treatment option is recruitment onto clinical trials specially in late stage of disease.

The presented case concerns the 62 year-old woman with metastatic GIST. In 2008 after gastrectomy she was recruited to EORTC 62024 clinical trial. Here she was randomly assigned to the observational arm. In 2009 due to non-resectable recurrence, the imatinib therapy was started and continued until 2014. At this time, she experienced disease progression so imatinib dose was doubled, and due to further progression – she received sunitinib. The tolerance of imatinib was satisfactory, but after sunitinib therapy - the dose modification was necessary due to toxicity at grade CTC3. In 2015, because of the further progression she received sorafenib over 12 months, and next re-treatment with imatinib and chemotherapy according to the ADIC with 4 months of response. Considering patient’s good performance status regardless the fifth line of treatment she was proposed the regorafenib treatment. After the first course, patient reported a definite improvement of quality of life and pain control. The main complications was the hand-foot syndrome and diarrheas (grade CTC2). The best response was partial response, nowadays patient disease is stable. In the case of further progression a clinical trial will be proposed.

Conclusions: In GIST patients, regorefenib as an single agent administered after progression on imatinib, sunitinib and sorafenib is effective and well tolerated treatment leading into clinical and radiological response.