Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience
Abstract The long‐term effects of tyrosine kinase inhibitors (TKIs), including imatinib, and surgical intervention on advanced gastrointestinal stromal tumor (GIST) were evaluated. All 379 patients had metastatic or recurrent GIST and started 400 mg/d imatinib at the Asan Medical Center in periods 1...
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Wiley
2019-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1994 |
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| author | Jwa Hoon Kim Min‐Hee Ryu Changhoon Yoo Heejung Chae Hana Na Moyoul Beck Beom Su Kim Moon‐Won Yoo Jeong Hwan Yook Byung Sik Kim Ki‐Hun Kim Chan Wook Kim Yoon‐Koo Kang |
| author_facet | Jwa Hoon Kim Min‐Hee Ryu Changhoon Yoo Heejung Chae Hana Na Moyoul Beck Beom Su Kim Moon‐Won Yoo Jeong Hwan Yook Byung Sik Kim Ki‐Hun Kim Chan Wook Kim Yoon‐Koo Kang |
| author_sort | Jwa Hoon Kim |
| collection | DOAJ |
| description | Abstract The long‐term effects of tyrosine kinase inhibitors (TKIs), including imatinib, and surgical intervention on advanced gastrointestinal stromal tumor (GIST) were evaluated. All 379 patients had metastatic or recurrent GIST and started 400 mg/d imatinib at the Asan Medical Center in periods 1 and 2 [2001‐2007 (33.2%) and 2008‐2014 (66.8%), respectively]. Men constituted 60.4%; median patient age and tumor size at the initiation of imatinib were 58.6 (14.6‐85.5) years and 51 (0‐324) mm, respectively, without differences between periods except for older age and less preimatinib surgery in period 2. Response and disease control rates with imatinib in measurable GIST were 63.1% and 94.3%, respectively, without differences between periods. More patients in period 2 underwent surgical resection for TKI‐responsive diseases within the first 2 years (24.9%, P = 0.006). With a median follow‐up of 6.1 years (2.5‐16.0) in survivors, median progression‐free survival (PFS) was 5.4 years [95% confidence interval (CI), 4.0‐6.9]. Subsequent sunitinib (P = 0.066) and regorafenib (P = 0.003) were more commonly administered in period 2. Median overall survival (OS) was 8.8 years (95% CI, 7.8‐9.7). PFS with imatinib (P = 0.002) and OS (P = 0.019) were significantly longer in period 2. Young age, smaller tumor size at the initiation of imatinib, KIT exon 11 mutation, surgical intervention, and period 2 were favorable factors for PFS and OS. Patients with advanced GIST showed better prognosis with the optimal use of imatinib, along with active surgical intervention and more common use of subsequent TKIs in period 2. |
| format | Article |
| id | doaj-art-aede1e5457f34f26aa500166828ca9c9 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-aede1e5457f34f26aa500166828ca9c92025-01-31T08:47:42ZengWileyCancer Medicine2045-76342019-03-01831034104310.1002/cam4.1994Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experienceJwa Hoon Kim0Min‐Hee Ryu1Changhoon Yoo2Heejung Chae3Hana Na4Moyoul Beck5Beom Su Kim6Moon‐Won Yoo7Jeong Hwan Yook8Byung Sik Kim9Ki‐Hun Kim10Chan Wook Kim11Yoon‐Koo Kang12Department of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul KoreaDepartment of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul KoreaDepartment of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul KoreaDepartment of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul KoreaDepartment of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul KoreaDepartment of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul KoreaDepartment of Oncology Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaAbstract The long‐term effects of tyrosine kinase inhibitors (TKIs), including imatinib, and surgical intervention on advanced gastrointestinal stromal tumor (GIST) were evaluated. All 379 patients had metastatic or recurrent GIST and started 400 mg/d imatinib at the Asan Medical Center in periods 1 and 2 [2001‐2007 (33.2%) and 2008‐2014 (66.8%), respectively]. Men constituted 60.4%; median patient age and tumor size at the initiation of imatinib were 58.6 (14.6‐85.5) years and 51 (0‐324) mm, respectively, without differences between periods except for older age and less preimatinib surgery in period 2. Response and disease control rates with imatinib in measurable GIST were 63.1% and 94.3%, respectively, without differences between periods. More patients in period 2 underwent surgical resection for TKI‐responsive diseases within the first 2 years (24.9%, P = 0.006). With a median follow‐up of 6.1 years (2.5‐16.0) in survivors, median progression‐free survival (PFS) was 5.4 years [95% confidence interval (CI), 4.0‐6.9]. Subsequent sunitinib (P = 0.066) and regorafenib (P = 0.003) were more commonly administered in period 2. Median overall survival (OS) was 8.8 years (95% CI, 7.8‐9.7). PFS with imatinib (P = 0.002) and OS (P = 0.019) were significantly longer in period 2. Young age, smaller tumor size at the initiation of imatinib, KIT exon 11 mutation, surgical intervention, and period 2 were favorable factors for PFS and OS. Patients with advanced GIST showed better prognosis with the optimal use of imatinib, along with active surgical intervention and more common use of subsequent TKIs in period 2.https://doi.org/10.1002/cam4.1994gastrointestinal stromal tumorimatinib mesylatesurvival |
| spellingShingle | Jwa Hoon Kim Min‐Hee Ryu Changhoon Yoo Heejung Chae Hana Na Moyoul Beck Beom Su Kim Moon‐Won Yoo Jeong Hwan Yook Byung Sik Kim Ki‐Hun Kim Chan Wook Kim Yoon‐Koo Kang Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience Cancer Medicine gastrointestinal stromal tumor imatinib mesylate survival |
| title | Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience |
| title_full | Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience |
| title_fullStr | Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience |
| title_full_unstemmed | Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience |
| title_short | Long‐term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors: A 14‐year, single‐center experience |
| title_sort | long term survival outcome with tyrosine kinase inhibitors and surgical intervention in patients with metastatic or recurrent gastrointestinal stromal tumors a 14 year single center experience |
| topic | gastrointestinal stromal tumor imatinib mesylate survival |
| url | https://doi.org/10.1002/cam4.1994 |
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