Guidelines
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2018; 24(46): 5189-5202
Published online Dec 14, 2018. doi: 10.3748/wjg.v24.i46.5189
Chinese consensus on management of tyrosine kinase inhibitor-associated side effects in gastrointestinal stromal tumors
Jian Li, Ming Wang, Bo Zhang, Xin Wu, Tian-Long Lin, Xiu-Feng Liu, Ye Zhou, Xin-Hua Zhang, Hao Xu, Li-Jing Shen, Jing Zou, Ping Lu, Dong Zhang, Wei-Jun Gu, Mei-Xia Zhang, Jian Pan, Hui Cao, Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association
Jian Li, Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, China
Ming Wang, Tian-Long Lin, Hui Cao, Department of Gastrointestinal Surgery, Reiji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
Bo Zhang, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Xin Wu, Department of General Surgery, the General Hospital of the People’s Liberation Army, Beijing 100853, China
Xiu-Feng Liu, Department of Oncology, The Chinese People’s Liberation Army 81st Hospital, Nanjing 210031, Jiangsu Province, China
Ye Zhou, Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Xin-Hua Zhang, Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Hao Xu, Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 320100, Jiangsu Province, China
Li-Jing Shen, Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200240, China
Jing Zou, Department of Respirology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200240, China
Ping Lu, Department of Dermatology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200240, China
Dong Zhang, Department of Nephrology, The General Hospital of the People’s Liberation Army, Beijing 100853, China
Wei-Jun Gu, Department of Endocrinology, The General Hospital of the People’s Liberation Army, Beijing 100853, China
Mei-Xia Zhang, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jian Pan, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Cao H designed the consensus and revised the final manuscript; Li J, Wang M, Zhang B, Wu X, Lin TL, Liu XF, Zhou Y, Zhang XH, and Xu H collected the data and performed different parts of this article according to different specialties; Shen LJ, Zou J, Lu P, Zhang D, Gu WJ, Zhang MX, and Pan J helped to collect the data and gave comments; Li J and Lin TL integrated the final manuscript. Li J, Wang M, Zhang B, Wu X, Lin TL, Liu XF, Zhou Y, Zhang XH, and Xu H contributed equally to this consensus.
Conflict-of-interest statement: All the authors report no conflicts of interest in this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Hui Cao, MD, Chief Doctor, Surgical Oncologist, Department of General Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, No. 160, Pujian Road, Pudong New District, Shanghai 200127, China. caohuishcn@hotmail.com
Telephone: +86-21-68383751 Fax: +86-21-58395057
Received: August 23, 2018
Peer-review started: August 23, 2018
First decision: October 5, 2018
Revised: November 4, 2018
Accepted: November 7, 2018
Article in press: November 8, 2018
Published online: December 14, 2018
Abstract

Tyrosine kinase inhibitors (TKIs) have improved the overall survival of patients with gastrointestinal stromal tumors (GISTs), but their side effects can impact dose intensity and, consequently, the clinical benefit. To date, no guideline or consensus has been published on the TKI-associated adverse reactions. Therefore, the Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association organized an expert panel discussion involving representatives from gastrointestinal surgery, medical oncology, cardiology, dermatology, nephrology, endocrinology, and ophthalmology to consider the systemic clinical symptoms, molecular and cellular mechanisms, and treatment recommendations of GISTs. Here, we present the resultant evidence- and experience-based consensus to guide the management of TKI-associated side events in clinical practice.

Keywords: Side effects, Gastrointestinal stromal tumor, Tyrosine kinase inhibitors, Consensus guideline, China

Core tip: This is the first consensus focusing on tyrosine kinase inhibitor (TKI)-associated side effects in gastrointestinal stromal tumors (GISTs). The authors include not only oncologist, oncology surgeon, but also doctors from other relative specialties, such as cardiology, dermatology, nephrology, and endocrinology. The content consists of clinical symptoms, mechanisms, and management. Because except for GISTs, TKIs in this consensus are also used in other tumors, this consensus will be helpful to many oncologists in different specialties.