Clinical outcomes of imatinib dose escalation versus sunitinib in first-line imatinib-failure gastrointestinal stromal tumour

被引:6
|
作者
Yang, Weili [1 ]
Li, Kai [1 ]
Yu, Jiren [1 ]
Shou, Chunhui [1 ]
Zhang, Qing [1 ]
Hong, Yanyun [1 ]
Sun, Jianyi [1 ]
Yu, Hang [1 ]
Gao, Yuan [1 ]
Shen, Qianyun [1 ]
Zhao, Zhicheng [1 ]
Zheng, Shusen [2 ]
机构
[1] Zhejiang Univ, Sch Med, Affiliated Hosp 1, Dept Gastrointestinal Surg, Hangzhou, Zhejiang, Peoples R China
[2] Zhejiang Univ, Sch Med, Affiliated Hosp 1, Dept Hepatopancreatobiliary Surg, 79 Qingchun Rd, Hangzhou, Zhejiang, Peoples R China
关键词
Gastrointestinal stromal tumours; gene mutation; sunitinib; survival; PROGNOSTIC-FACTORS; EFFICACY; MESYLATE; SAFETY; KIT; PROGRESSION; RECURRENCE; BENEFIT; TRIAL;
D O I
10.1080/00365521.2018.1518484
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
引用
收藏
页码:1328 / 1334
页数:7
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