Abstract
PurposeLong-term continuous imatinib is recommended for adult patients with unresectable and/or metastatic KIT+ gastrointestinal stromal tumors (GIST) as long as the patient continues to benefit. In the adjuvant setting, recent findings indicate that patients at considerable risk of recurrence should receive at least 3 years of imatinib. Because imatinib is often administered for prolonged periods, proper management of imatinib-associated adverse events is crucial.Case reportWe report a 56-year-old man with metastatic KIT+ GIST of the liver who had Grade 3 imatinib intolerance (skin rash) when treatment was started. The rash was managed with antihistamine treatment (Dexchlorpheniramine maleate 4 mg per day) and several temporary (up to 2 weeks) dose interruptions. The patient’s skin rash partially improved, and he tolerated gradual reintroduction of imatinib over several months. The patient maintained imatinib 400 mg/d, and tolerated it during the 2 years when he was on antihistamine treatment. After 2 years, the patient continued imatinib therapy without having to take antihistamines. The patient responded according to RECIST 1.1 and Choi to imatinib treatment for his metastatic GIST (partial response). As of September, 2012, the patient has been on imatinib therapy for 131 months and remains progression free.ConclusionsThe results of this case report demonstrated that a patient with metastatic KIT+ GIST who was initially intolerant to imatinib maintained, and responded to imatinib therapy after treatment of an imatinib-associated adverse effect. These results suggest that initial intolerance to imatinib should not necessarily result in treatment discontinuation, as these adverse effects, when managed properly, may be tolerated and may decrease over time.
Highlights
Imatinib mesylate is approved for the treatment of adult patients with unresectable and/or metastatic KIT+ gastrointestinal stromal tumor (GIST) and for the adjuvant treatment of adult patients following resection of primary gastrointestinal stromal tumors (GIST) [1]
The results of this case report demonstrated that a patient with metastatic KIT+ GIST who was initially intolerant to imatinib maintained, and responded to imatinib therapy after treatment of an imatinib-associated adverse effect
These results suggest that initial intolerance to imatinib should not necessarily result in treatment discontinuation, as these adverse effects, when managed properly, may be tolerated and may decrease over time
Summary
Early recognition and proper management of imatinib-associated adverse effects may help GIST patients maintain imatinib therapy and achieve optimal clinical efficacy. 9. Demetri GD, Wang Y, Wehrle E, et al: Imatinib plasma levels are correlated with clinical benefit in patients with unresectable/metastatic gastrointestinal stromal tumors. Von Mehren M, Heinrich MC, Joensuu H, et al: Follow-up results after 9 years (yrs) of the ongoing, phase II B2222 trial of imatinib mesylate (IM) in patients (pts) with metastatic or resectable KIT+ gastrointestinal stromal tumors (GIST). Doi:10.1186/2045-3329-2-23 Cite this article as: Blay: Management of imatinib-associated skin rash in a patient with metastatic gastrointestinal stromal tumor: a case report. Competing interests Jean-Yves Blay received research grants and honoraria from Novartis, Pfizer, GlaxoSmithKline, Roche, and PharmaMar. Authors’ contributions JYB managed the patient in the clinic, collected and analyzed data, critically revised each draft of the manuscript, and approved the final version
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
