Severe skin reaction in a patient with gastrointestinal stromal tumor treated with imatinib mesylate.

Imatinib mesylate is a selective protein kinase inhibitor, highly active in patients with chronic myeloid leukemia (CML) and gastrointestinal stromal tumors (GISTs). Cutaneous toxicity, a well-recognized, dose-related side-effect of imatinib mesylate, has been reported in 18 to 69% of patients with GIST treated with doses ranging from 400 to 800 mg once a day. In this case-report a severe skin reaction observed in a patient with GIST treated with imatinib mesylate, in an adjuvant setting and whose severity led to definitive drug discontinuation, is described. Therapeutic management and clinical course are illustrated.

[1]  Rossella Bertulli,et al.  Progression-free survival in gastrointestinal stromal tumours with high-dose imatinib: randomised trial , 2004, The Lancet.

[2]  C. Prins,et al.  Acute Generalized Exanthematous Pustulosis Associated with STI571 in a Patient with Chronic Myeloid Leukemia , 2001, Dermatology.

[3]  J. Saurat,et al.  Cutaneous reactions to STI571. , 2001, The New England journal of medicine.

[4]  Shan Zeng,et al.  The c-KIT mutation causing human mastocytosis is resistant to STI571 and other KIT kinase inhibitors; kinases with enzymatic site mutations show different inhibitor sensitivity profiles than wild-type kinases and those with regulatory-type mutations. , 2002, Blood.

[5]  K. Antman,et al.  Imatinib mesylate--a new oral targeted therapy. , 2002, The New England journal of medicine.

[6]  D. Schadendorf,et al.  Dose-dependent severe cutaneous reactions to imatinib , 2003, British Journal of Cancer.

[7]  Sigrid Stroobants,et al.  Update of phase I study of imatinib (STI571) in advanced soft tissue sarcomas and gastrointestinal stromal tumors: a report of the EORTC Soft Tissue and Bone Sarcoma Group. , 2002, European journal of cancer.

[8]  T. Holyoake,et al.  A spectrum of skin reactions caused by the tyrosine kinase inhibitor imatinib mesylate (sti 571, glivec®) , 2003, British journal of haematology.

[9]  J. Verweij,et al.  Imatinib pharmacokinetics in patients with gastrointestinal stromal tumour: a retrospective population pharmacokinetic study over time. EORTC Soft Tissue and Bone Sarcoma Group , 2005, Cancer Chemotherapy and Pharmacology.

[10]  R. Latagliata,et al.  Early and tardive skin adverse events in chronic myeloid leukaemia patients treated with imatinib , 2005, European journal of haematology.

[11]  J. Blay,et al.  Outcome of patients with advanced gastro-intestinal stromal tumours crossing over to a daily imatinib dose of 800 mg after progression on 400 mg. , 2005, European journal of cancer.

[12]  A. D. Van den Abbeele,et al.  Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. , 2002, The New England journal of medicine.

[13]  C. Heldin,et al.  Inhibition of platelet-derived growth factor receptors reduces interstitial hypertension and increases transcapillary transport in tumors. , 2001, Cancer research.