Piotr Rutkowski, Zbigniew I Nowecki, Maria Debiec-Rychter, Urszula Grzesiakowska, Wanda Michej, Agnieszka Woźniak, Janusz A Siedlecki, Janusz Limon, Anna Jerzak vel Dobosz, Michał Kakol, Czesław Osuch, Włodzimierz Ruka
Journal of cancer research and clinical oncology 2007 SepTo 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 > or = 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 > or = 2, high baseline neutrophils count (>5 x 10(9)/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.
Piotr Rutkowski, Zbigniew I Nowecki, Maria Debiec-Rychter, Urszula Grzesiakowska, Wanda Michej, Agnieszka Woźniak, Janusz A Siedlecki, Janusz Limon, Anna Jerzak vel Dobosz, Michał Kakol, Czesław Osuch, Włodzimierz Ruka. Predictive factors for long-term effects of imatinib therapy in patients with inoperable/metastatic CD117(+) gastrointestinal stromal tumors (GISTs). Journal of cancer research and clinical oncology. 2007 Sep;133(9):589-97
PMID: 17458563
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