期刊
CANCERS
卷 15, 期 15, 页码 -出版社
MDPI
DOI: 10.3390/cancers15153879
关键词
gastrointestinal stromal tumor; GIST; imatinib; adjuvant therapy; molecular targeted therapy; KIT; platelet-derived growth factor receptor alpha; survival
类别
Gastrointestinal stromal tumor (GIST) is a common sarcoma arising from the gastrointestinal tract, mainly the stomach, with varying malignancy potential. Surgery is generally curative for localized GISTs. Adjuvant imatinib has been shown to improve recurrence-free survival and overall survival (OS) in high-risk GIST patients with an imatinib-sensitive mutation.
Simple Summary Gastrointestinal stromal tumor (GIST) is the most common type of sarcoma that arises from the gastrointestinal tract, most frequently from the stomach. The malignancy potential of GISTs varies greatly; some are aggressive cancers. Most localized GISTs are cured with surgery. Recent results show that adjuvant imatinib substantially improves the recurrence-free survival and overall survival of GIST patients who have a high risk for recurrence after surgery if GIST harbors an imatinib-sensitive mutation in KIT or PDGFRA and adjuvant imatinib is administered long enough after surgery, currently for 3 years. Adjuvant imatinib improves the recurrence-free survival and overall survival (OS) of patients with gastrointestinal stromal tumors (GISTs) who have a high risk of recurrence after surgery and is now considered standard treatment. Yet, OS benefit has been demonstrated in only one randomized study, the Scandinavian Sarcoma Group XVIII/AIO trial, where patients with high-risk GISTs were allocated to either 1 year or 3 years of adjuvant imatinib. SSGXVIII/AIO is also the only randomized trial in which adjuvant imatinib duration exceeding 2 years was evaluated. In this trial, the 3-year treatment led to a 45% reduction in the risk of death during the first 10 years that followed random allocation even though some of the patients did not have GISTs at tumor histology review, had mutations now known to be imatinib-resistant or had non-localized disease at study entry. In the subgroup of patients who had KIT exon 11 deletion/indel mutation, the reduction in the risk of death was 66% in favor of the longer treatment. Proper patient selection is of crucial importance since many patients are cured with surgery. Little evidence for OS benefit is available from randomized trials for patients whose GIST harbors KIT exon 9 mutation, KIT insertion mutation, PDGFRA D842V mutation, or lacks KIT and PDGFRA mutations. Adjuvant imatinib improves OS substantially if high-risk GISTs can be identified, treatment duration is long enough, and GISTs harbor an imatinib-sensitive mutation.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据