Oncologist Consultation Conclusion — English Translation

Source (Ukrainian original): docs_eng/2026_new/Oncologist_conclusion_Sunitinib_switch_30.07.2026.pdf

Facility: LISOD (Israeli Oncology Hospital), Medixray International Group LLC

Patient: Zherlitsyna Anastasiia Stanislavivna, ID 110889, DOB 25.04.1976

Consulting physician: Dr. Yermakov Maksym Serhiyovych, oncologist

Form: Specialist Consultation Conclusion, form 028/o

Diagnosis (ICD-10: C16.9 - Malignant neoplasm of stomach, unspecified)

Leiomyosarcoma of the uterine body, T2NxM1, secondary involvement of liver and peritoneum. Status after 4 cycles of chemotherapy per Gemcitabine + Docetaxel + Avastin protocol with disease progression in the liver (per CT/MRI from 10/2022). C-KIT and MET mutations detected (ONCOMINE). Status after Pazopanib treatment (05-12/01/2023) with development of posterior reversible encephalopathy syndrome and positive CT dynamics.

01/2023 - repeat liver biopsy. Histology: metastasis of uterine leiomyosarcoma. Status after 3 cycles of chemotherapy per Trabectedin protocol with negative radiological dynamics (PET/CT from 11/04/2023). Suspected synchronous gastric neoplasia (GIST?). Status after EUS-FNA biopsy of stomach, core biopsy of liver - histologically gastrointestinal stromal tumor (GIST) of the stomach, GIST metastasis to liver (CSD).

08/2023 - status after 4 months of Imatinib treatment with pronounced positive radiological (PET/CT) response.
03/2025 - status after 2 years of Imatinib treatment with positive clinical picture.
05/2025 - stable radiological dynamics on Imatinib treatment.
07/2026 - return of mural (wall) components in known liver lesions while on Imatinib therapy for 3.5 years.

Recommendations

Switch to Sunitinib therapy, 50 mg, days 1-28, followed by a 2-week break.

Oncologist follow-up + PET/CT for comparison, or CT of chest, abdomen and pelvis with contrast, in 3-4 cycles.

Date: 30.07.2026

Oncologist: Yermakov M.S.

[Translation note: plain-language English translation of the Ukrainian original for reference purposes; not a certified medical translation.]