1. Survival of advanced/recurrent gastrointestinal stromal tumors treated with tyrosine kinase inhibitors in Taiwan: a nationwide registry study.
- Author
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Tsai HJ, Shan YS, Yang CY, Hsiao CF, Tsai CH, Wang CC, Lin MT, Ting CF, Chan DC, Chen TH, Yen CC, Chen YY, Lin HY, Yeh TS, Ho CL, Shieh TY, Bai LY, Hsu JT, Chen IS, Chen LT, and Yeh CN
- Subjects
- Humans, Female, Male, Taiwan epidemiology, Middle Aged, Aged, Adult, Sunitinib therapeutic use, Imatinib Mesylate therapeutic use, Prognosis, Aged, 80 and over, Gastrointestinal Neoplasms drug therapy, Gastrointestinal Neoplasms mortality, Gastrointestinal Neoplasms genetics, Gastrointestinal Neoplasms pathology, Phenylurea Compounds therapeutic use, Pyridines therapeutic use, Survival Rate, Progression-Free Survival, Kaplan-Meier Estimate, Tyrosine Kinase Inhibitors, Gastrointestinal Stromal Tumors drug therapy, Gastrointestinal Stromal Tumors mortality, Gastrointestinal Stromal Tumors genetics, Gastrointestinal Stromal Tumors pathology, Protein Kinase Inhibitors therapeutic use, Registries, Proto-Oncogene Proteins c-kit genetics, Receptor, Platelet-Derived Growth Factor alpha genetics, Mutation, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local genetics
- Abstract
Background: Most gastrointestinal stromal tumors (GISTs) harbor c-KIT or PDGFRA mutations. Administration of tyrosine kinase inhibitors (TKIs) has significantly improved the survival of patients with GISTs. We aimed to evaluate the clinical outcome of advanced or recurrent GIST patients in Taiwan., Methods: Patients diagnosed between 2010 and 2020 were enrolled. The collected data included baseline characteristics, treatment pattern, treatment outcome, genetic aberrations and survival status. Progression-free survival (PFS) and overall survival (OS) were analyzed and plotted with the Kaplan-Meier method. Cox regression analysis was used to analyze the prognostic factors of survival., Results: A total of 224 patients with advanced or recurrent GISTs treated with TKIs were enrolled. All patients received imatinib treatment. Ninety-three and 42 patients received sunitinib and regorafenib treatment, respectively. The 48-month PFS and OS rates for patients treated with imatinib were 50.5% and 79.5%, respectively. c-KIT exon 9 and PDGFRA mutations were prognostic factors for a poor PFS and PDGFRA mutation was a prognostic factor for a poor OS in patients treated with imatinib in multivariate Cox regression analysis. The median PFS of patients who received sunitinib treatment was 12.76 months (95% confidence interval (CI), 11.01-14.52). Patients with c-KIT exon 9 mutations had a longer PFS than those with other genetic aberrations. The median PFS of patients treated with regorafenib was 7.14 months (95% CI, 3.39-10.89)., Conclusions: We present real-world clinical outcomes for advanced GIST patients treated with TKIs and identify mutational status as an independent prognostic factor for patient survival., (© 2024. The Author(s).)
- Published
- 2024
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