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- Title
Predictive factors for long-term effects of imatinib therapy in patients with inoperable/metastatic CD117(+) gastrointestinal stromal tumors (GISTs).
- Authors
Rutkowski, Piotr; Nowecki, Zbigniew I.; Dębiec-Rychter, Maria; Grzesiakowska, Urszula; Michej, Wanda; Woźniak, Agnieszka; Siedlecki, Janusz A.; Limon, Janusz; vel Dobosz, Anna Jerzak; Kąkol, Michał; Osuch, Czesław; Ruka, Włodzimierz
- Abstract
To analyze the outcomes of treatment and factors predicting effects of imatinib (IM) therapy in inoperable/metastatic gastrointestinal stromal tumors (GIST) CD117(+) patients. We identified 232 patients in a prospectively collected Clinical GIST Registry with advanced inoperable/metastatic GIST treated with IM 400-800 mg daily (129 males and 103 females and median age 56 years). Median follow-up time was 26 months. The estimated 3-year progression-free survival (PFS; calculated from the date of the start of IM) was 54% and median PFS was 40.5 months. The following factors significantly and negatively influenced PFS in univariate analysis: poor baseline World Health Organization (WHO) performance status ≥2 ( P < 0.00001), tumor genotype indicating other than KIT exon 11 isoform ( P = 0.005), baseline high neutrophils count ( P < 0.00001), age <45 years at the diagnosis ( P = 0.04), mitotic index >10/50 high-power fields (HPF) ( P = 0.001), GIST histological type other than spindle-cell ( P = 0.03), baseline low albumin level ( P = 0.0005), low baseline hemoglobin level ( P < 0.00001), and primary overtly malignant tumors (unresectable and/or metastatic lesions at presentation) ( P = 0.05). We identified four factors negatively affecting PFS, statistically significant ( P < 0.05) in multivariate analysis: baseline poor WHO performance status ≥2, high baseline neutrophils count (>5 × 109/l), tumor genotype indicating the presence of non-exon 11 KIT mutant and mitotic index >10/50 HPF. We confirmed that many advanced GIST patients benefit from IM therapy for a prolonged time, although resistance to therapy is observed. We identified four independent biological factors influencing the PFS during long-term IM therapy.
- Subjects
IMATINIB; GASTROINTESTINAL stromal tumors; GASTROINTESTINAL tumors; GENETIC polymorphisms; NEUTROPHILS
- Publication
Journal of Cancer Research & Clinical Oncology, 2007, Vol 133, Issue 9, p589
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-007-0202-4