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Clinical Trial
. 2008 Nov 20;26(33):5360-7.
doi: 10.1200/JCO.2008.17.4284. Epub 2008 Oct 27.

"VSports注册入口" Correlation of kinase genotype and clinical outcome in the North American Intergroup Phase III Trial of imatinib mesylate for treatment of advanced gastrointestinal stromal tumor: CALGB 150105 Study by Cancer and Leukemia Group B and Southwest Oncology Group

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Clinical Trial

VSports手机版 - Correlation of kinase genotype and clinical outcome in the North American Intergroup Phase III Trial of imatinib mesylate for treatment of advanced gastrointestinal stromal tumor: CALGB 150105 Study by Cancer and Leukemia Group B and Southwest Oncology Group

Michael C Heinrich et al. J Clin Oncol. .

Abstract

Purpose: Imatinib mesylate is standard treatment for patients who have advanced gastrointestinal stromal tumor (GIST), but not all patients benefit equally VSports手机版. In previous studies, GIST genotype correlated with treatment outcome and optimal imatinib dosing. .

Patients and methods: We examined the relationship between kinase genotype and treatment outcome for 428 patients enrolled on the North American phase III study SWOG S0033/CALGB 150105 and treated with either 400 mg or 800 mg daily doses of imatinib. V体育安卓版.

Results: The presence of KIT exon 11-mutant genotype (n = 283) correlated with improved treatment outcome when compared with KIT exon 9-mutant (n = 32) and wild-type (WT; n = 67) genotypes for objective response (complete response [CR]/partial response [PR], 71. 7% v 44. 4% [P = . 007]; and 44. 6% [P = . 0002], respectively); time to tumor progression (TTP; median 24. 7 months v 16. 7 and 12. 8 months, respectively); and overall survival (OS; median 60. 0 months v 38. 4 and 49. 0 months, respectively). The survival outcomes for patients with exon 9-mutant, exon 11-mutant or WT GIST were not affected by imatinib dose. However, there was evidence of improved response rates for patients with exon 9-mutant tumors treated with imatinib 800 mg versus 400 mg (CR/PR, 67% v 17%; P = . 02). Patients who had CD117-negative GIST had similar TTP but inferior OS compared with patients who had CD117-positive disease, which suggests that patients who have CD117-negative GIST may benefit from imatinib treatment. In addition, we identified novel but rare mutations of the KIT extracellular domain (exons 8 and 9). V体育ios版.

Conclusion: We confirmed the favorable impact of KIT exon 11 genotype when compared with KIT exon 9 and wild-type genotype for patients with advanced GIST who are treated with imatinib. VSports最新版本.

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Figures

Fig 1.
Fig 1.
CONSORT diagram of Cancer and Leukemia Group B study 150105. GIST, gastrointestinal stromal tumor; Pos, positive.
Fig 2.
Fig 2.
Correlation of gastrointestinal stromal tumor (GIST) genotype and time to progression or overall survival for patients with CD117-positive GISTs.
Fig 3.
Fig 3.
Correlation of tumor genotype (KIT exon 9–mutant, KIT exon 11–mutant, or wild-type tumors), imatinib dose (400 mg [IM400] v 800 mg [IM800]), and time to progression and overall survival for patients with CD117-positive gastrointestinal stromal tumors.
Fig 4.
Fig 4.
Comparison of time to progression and overall survival for patients with CD117-positive and CD117-negative gastrointestinal stromal tumors.

References

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    1. Heinrich MC, Griffith DJ, Druker BJ, et al: Inhibition of c-kit receptor tyrosine kinase activity by STI 571, a selective tyrosine kinase inhibitor. Blood 96:925-932, 2000 - PubMed
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    1. Joensuu H, Roberts PJ, Sarlomo-Rikala M, et al: Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med 344:1052-1056, 2001 - PubMed
    1. van Oosterom AT, Judson I, Verweij J, et al: Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: A phase I study. Lancet 358:1421-1423, 2001 - PubMed

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