Aim: The majority of available data on the clinical efficacy of sunitinib in patients with imatinib-resistant or -intolerant gastrointestinal stromal tumours (GISTs) are from studies of western populations. We investigated the clinical outcomes of imatinib dose escalation versus sunitinib in first-line imatinib-failure Asian GIST patients to further guide clinical treatment. Methods: Patients received imatinib dose escalation and a shift to sunitinib (Group A) or a direct shift to sunitinib (Group B). The objective tumour response was assessed according to Choi's criteria. Progression-free survival (PFS) and overall survival (OS) were calculated. The relationship between genetic mutation and survival was analysed. Results: In total, 40 patients who fulfilled the inclusion criteria were recruited. The differences in survival between Group A and Group B were not significant for PFS (p = .776) or OS (p = .219). For patients with KIT exon 11 mutation, a trend towards a better PFS was found in Group B (p = .122), OS of Group B was better than Group A (p = .013). The median PFS and OS of sunitinib treatment were 8 and 24 months, respectively, and a clinical benefit was observed in 80%. Patients with KIT exon 11 mutations had better PFS compared to those with KIT exon 9 mutations or wild-type GISTs (p = .017, p = .040, respectively). Conclusions: Both imatinib dose escalation and sunitinib were optional in Asian patients after failure of first-line imatinib, and patients with KIT exon 11 mutation benefited more from a direct shift to sunitinib.
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Huang, Shaoqing
Liu, Xing
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Fujian Med Univ, Affiliated Union Hosp, Dept Gast Surg, Fuzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Liu, Xing
Guo, Xiaodan
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Guo, Xiaodan
Wu, Hui
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Wu, Hui
Lu, Huishan
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Fujian Med Univ, Affiliated Union Hosp, Dept Colorectal Surg, Fuzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Lu, Huishan
Pan, Zhizhong
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Sun Yat Sen Univ, Dept Colorectal Surg, Canc Ctr, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Pan, Zhizhong
Cai, Shirong
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Cai, Shirong
Wu, Xiaojun
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Sun Yat Sen Univ, Dept Colorectal Surg, Canc Ctr, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
Wu, Xiaojun
Zhang, Xinhua
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Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R ChinaSun Yat Sen Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Guangzhou, Peoples R China
机构:
Aichi Canc Ctr Hosp, Dept Gastroenterol, Chikusa Ku, Nagoya, Aichi 4648681, JapanAichi Canc Ctr Hosp, Dept Gastroenterol, Chikusa Ku, Nagoya, Aichi 4648681, Japan
Sawaki, Akira
Kanda, Tatsuo
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Niigata Univ Hosp, Digest & Gen Surg Div 2, Chuo Ku, Niigata 9518510, JapanAichi Canc Ctr Hosp, Dept Gastroenterol, Chikusa Ku, Nagoya, Aichi 4648681, Japan
Kanda, Tatsuo
Komatsu, Yoshito
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Hokkaido Univ Hosp, Ctr Canc, Dept Canc Chemotherapy, Kita Ku, Sapporo, Hokkaido 0608648, JapanAichi Canc Ctr Hosp, Dept Gastroenterol, Chikusa Ku, Nagoya, Aichi 4648681, Japan
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UJOMM HEH & Conticanet FP6 018806, Ctr Leon Berard, F-69373 Lyon, France
Univ Lyon 1, F-69622 Lyon, FranceDana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Blay, J. Y.
Casali, P. G.
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Ist Nazl Tumori, I-20133 Milan, ItalyDana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Casali, P. G.
Le Cesne, A.
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Inst Gustave Roussy, F-94805 Villejuif, FranceDana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Le Cesne, A.
Stephenson, P.
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Rho Inc, Chapel Hill, NC 27517 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Stephenson, P.
DePrimo, S. E.
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Pfizer Oncol, San Diego, CA 92121 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
DePrimo, S. E.
Harmon, C. S.
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Pfizer Oncol, San Diego, CA 92121 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Harmon, C. S.
Law, C. N. J.
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Pfizer Oncol, San Diego, CA 92121 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Law, C. N. J.
Morgan, J. A.
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机构:
Dana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Morgan, J. A.
Ray-Coquard, I.
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机构:
Hosp Civils Lyon, Ctr Leon Berard, Dept Med Oncol, F-69008 Lyon, France
Hosp Civils Lyon, EA SIS 4128, F-69008 Lyon, FranceDana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Ray-Coquard, I.
Tassell, V.
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机构:
Pfizer Oncol, San Diego, CA 92121 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Tassell, V.
Cohen, D. P.
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机构:
Pfizer Oncol, San Diego, CA 92121 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
Cohen, D. P.
Demetri, G. D.
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Dana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USADana Farber Canc Inst, Ctr Sarcoma & Bone Oncol, Boston, MA 02115 USA
机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Park, Inkeun
Ryu, Min-Hee
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Ryu, Min-Hee
Sym, Sun Jin
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Sym, Sun Jin
Lee, Sung Sook
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Lee, Sung Sook
Jang, Geundoo
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Jang, Geundoo
Kim, Tae Won
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Kim, Tae Won
Chang, Heung Moon
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机构:
Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Chang, Heung Moon
Lee, Jae-Lyun
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Lee, Jae-Lyun
Lee, Hyoungnam
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea
Lee, Hyoungnam
Kang, Yoon-Koo
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Univ Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South KoreaUniv Ulsan, Coll Med, Asan Med Ctr, Dept Internal Med,Div Oncol, Seoul 138736, South Korea