Chinese Clinical Oncology

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Analyses of clinical features for responders on imatinib mesylate to Chinese patients with advanced gastrointestinal stromal tumor as first-line treatment: multi-center, eight years followed-up outcome

LIU Xiufeng, LI Jian, LI Yong, ZHOU Yongjian, SHEN Lin, LU Huishan, QIN Shukui.   

  1. Department of Medical Oncology, PLA Cancer Center, 81 Hospital of PLA, Nanjing 210002, China
  • Received:2015-11-26 Revised:2015-12-19 Online:2016-02-29 Published:2016-02-29
  • Contact: QIN Shukui

Abstract: Objective To analyze retrospectively clinical pathology features for responders on imatinib mesylate (IM) to Chinese patients with advanced gastrointestinal stromal tumor (GIST) as first-line treatment, and provide evidence for long-term use of IM. Methods Clinical pathology features for responders (including CR, PR and SD) on IM as firstline treatment to Chinese patients with advanced GIST were collected from four comprehensive Rank 3, Grade A hospitals. All patients were pathologically diagnosed before 31 Oct, 2007 with a more than 8-year life span. Kaplan-Meier method (Log-rank test) was used for survival statistics and Cox proportional hazard model (Enter method) for multivariable independent risk factors analyses. Results Till deadline of followed-up,92 cases met the criteria for survival analyses, in which there were 25 cases died (27.2%). Medium time to progression (TTP) and overall survival (OS) were 970 months (95%CI: 86.2-107.8) and 115.0 months (95%CI: 105.3-124.7), respectively. The 1,3,5,8,10-year TTP rates were 94.6%, 86.9%, 74.8%, 49.0% and 24.4%; Accordingly, OS rates were 96.7%, 91.3%, 85.8%, 76.5% and 67.0%, respectively. Beneficial predictors for TTP in univariable analyses included female, age less than 60 years old, tumor diameter less than 10 cm and exon 11 mutation, in coincidence with the result of multivariable analyses. Primary location, mitotic rate, tumor rapture, recurrence site and different response maybe not act as predictors in setting of IM continuous administration. As for OS, only tumor diameter less than 10 cm, exon 11 mutation and CR/PR patients have longer survival. After calibrated, no independent predictive risk factors found in multivariable analyses. Conclusion For GIST patients with tumor diameter less than 10 cm, exon 11 mutation and CR/PR on IM, IM maybe provide longer survival in firstline setting and continuous using is recommended.

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