PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media56278810.18565/pharmateca.2023.6-7.36-41ReviewsОбзорыReview ArticleGastrointestinal stromal tumors: prospects for drug therapy of metastatic or inoperable formsГастроинтестинальные стромальные опухоли: перспективы лекарственной терапии метастатических или неоперабельных формhttps://orcid.org/0000-0003-4754-2352AbramovMikhail E.АбрамовМихаил Евгеньевич
Russian Federation

Cand. Sci. (Med.), Senior Researcher at the Oncological Department of Medicinal Methods of Treatment (Chemotherapeutic) № 4

к.м.н., старший науч. сотр. онкологического отделения лекарственных методов лечения (химиотерапевтическое) № 4 Научно-исследовательского института клинической онкологии

abramovm67@mail.ruhttps://orcid.org/0000-0002-7313-4013TikhomirovaT. E.ТихомироваТ. Е.
Russian Federation
abramovm67@mail.ruhttps://orcid.org/0000-0002-7871-0358RyabishinaO. E.РябишинаО. Е.
Russian Federation
abramovm67@mail.ruhttps://orcid.org/0000-0003-4443-9974RumyantsevA. A.РумянцевА. А.
Russian Federation
abramovm67@mail.ruhttps://orcid.org/0000-0002-6104-7473TyulyandinaA. S.ТюляндинаА. С.
Russian Federation

Department of Oncology, N.V. Sklifosovsky Institute of Clinical Medicine

кафедра онкологии Института клинической медицины им. Н.В. Склифосовского

abramovm67@mail.ruN.N. Blokhin National Medical Research Center of OncologyНациональный медицинский исследовательский центр онкологии им. Н.Н. БлохинаSechenov UniversityПервый МГМУ им. И.М. Сеченова (Сеченовский Университет)22072023306/736412107202321072023Copyright ©; 2023, Bionika MediaCopyright ©; 2023, ООО «Бионика Медиа»2023Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/562788

Gastrointestinal stromal tumors (GISTs) are the most common gastrointestinal mesenchymal tumors. Treatment of metastatic GISTs is determined by the molecular subtype of the tumor. The use of tyrosine kinase inhibitors, in particular imatinib, which is used as the standard first line treatment for metastatic tumors has been a revolution in the treatment of GIST. Despite the high efficacy of the drug, most patients develop resistance to the treatment, usually after 2–3 years. In the second and third lines of treatment, such drugs as sunitinib and regorafenib are used, respectively. In 2020, the FDA approved ripretinib as a fourth-line treatment, and in the presence of a mutation in the 18th exon of the PDGFRA gene; avapritinib began to be used from the same year. This review article describes standards and therapeutic approaches for the treatment of metastatic GISTs.

Гастроинтестинальные стромальные опухоли (ГИСО) являются наиболее распространенными мезенхимальными опухолями желудочно-кишечного тракта. Лечение метастатических ГИСО определяется молекулярным подтипом опухоли. Революцией в лечении ГИСО стало применение тирозинкиназных ингибиторов, в частности иматиниба, который используется в качестве стандартной первой линии лечения метастатических опухолей. Несмотря на высокую эффективность препарата, у большей части пациентов развивается резистентность к проводимому лечению, обычно через 2–3 года. Во второй и третьей линях лечения применяются такие препараты, как сунитиниб и регорафениб соответственно. В качестве четвертой линии лечения FDA в 2020 г. одобрило рипретиниб, а при наличии мутации в 18-й экзоне гена PDGFRA с того же года стал применяться авапритиниб. В данной обзорной статье описаны стандарты и терапевтические подходы к лечению метастатических ГИСО.

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