ASCO 2020: 10-year follow-up results for 3 or 1 year Imatinib-assisted treatment of high-risk gastrointestinal mesoplasmic tumors
-
Last Update: 2020-05-29
-
Source: Internet
-
Author: User
Search more information of high quality chemicals, good prices and reliable suppliers, visit
www.echemi.com
Gastrointestinal mesothelioma (GIST) is a common type of sarcoma, and several factors closely related to prognosis are tumor nuclei, tumor size, site and tumor rupture, the current risk classification criteria are also based on these parametersAlthough only an extension of RFS was observed in previous 1-year (Z9001) and two-year clinical trials of assisted therapy (both of which included some patients with low risk), the results of both RFS and OS extensions in high-risk patients, the 3-year SSGXVIII/AIO study of complementary therapy, were not clearKIT and PDGFRA gene mutations are the drivers of most GIST, of which KIT mutations are most commonly seen as the missing mutations of 11 exons, which often cover the key 557/558 cositends, which have poorer prognosis, while insertion, replication mutations and PDGFRA mutations are relatively goodHowever, relying on a simple type of genetic mutation to determine the patient's prognosis, the difference is very large, the prognosis is also related to the number of nuclear division, which suggests that the gene type may be along with other genetic characteristics, affecting the clinical biology behavior of GISTAt present, gene mutation as the basis for guiding the clinical use of GIST has been widely used, different gene mutants have inconsistent drug response, although PDGFRA exonome 18 D842V mutation patients are resistant to IM, but most OF THE KIT-11 missing mutation patients are sensitive to IM, KIT-9 mutation of late patients are more inclined to benefit from high-dose IM treatmentBut in patients with KIT and PDGFRA mutations, there is no evidence that extended the relationship between complementary treatment and patient prognosisassisted postoperative treatment of Imatinib can improve postoperative non-recurrent survival (RFS) in patients with gastrointestinal mesothelioma (GIST)It is not yet clear whether total survival (OS) can be improved, and only one of the three large randomized trials in Imatini (SSGXVIII/AIO, NCT00116935) improved the OS, and its statistical significance was criticalThis study was designed to assess long-term OS in patients who participated in the SSGXVIII/AIO trialSSGXVIII/AIO is an open label, random (1:1), multicenter Phase III trialFrom February 4, 2004 to September 29, 2008, 400 patients who underwent GIST surgery and had a high risk of recurrence were included in the study, which was given to Imartinibly for 12 or 36 months of oral administration for 400 mg per day after surgery, in accordance with the revised National Institutes of Health Consensus standardsThe primary focus of the study was RFS, and the secondary endpoints included OS and therapeutic safetyA total of 341 patients with KIT and PDGFRA gene mutations were eventually reviewed by a central pathologist, of whom 175 were men and 166 were women, with a median age of 62 years at the time of the study, with a median follow-up time of 88 months (range) 0.1 to 114 months; A total of 274 patients (80.4%) had KIT gene mutations, 43 (12.6%) had PDGFRA gene mutations, 24 cases (7%) were wild, no gene mutations were foundInsertion or repeated mutations of PDGFRA mutations and KIT-11 indicate rfS extension, while KIT-9 mutations have poor prognosisKIT exoskeleton 11 missing or inserted-missing mutants, patients receiving 3 years of assisted treatment with Imatinib were longer than 1-year assisted treatment RSRs with RFS, 71% and 41.3% (P 0.001) respectively, while in patients with other mutations, three-year assisted therapy and 1-year comparison did not show significant benefitsAuxiliary treatment 11 missing involving 557 and/or 558 cositands, or those with pTrp557-Lys558del due to deficiency, had shorter RFS, but there was no significant RFS difference in the 3-year group of Imatinib therapy Similarly, in the subgroup analysis of KIT exogenous 11 missing mutant imatinib assisted 1 year group, the number of nuclear splits was higher than the median, the RFS was worse, and the auxiliary therapy for 3 years there was no significant difference results: the median follow-up time was 119 months In the intentional treatment population, 194 RFS events and 96 OS events were recorded In the 36-month group, the RFS rates were 71.4% and 52.5% for 5 years and 52.5% in 10-month groups, and 53.0% and 41.8% in the 12-month group (HR -0.66, 95% CI 0.49-0.87; P- 0.003) In the 36-month group, the OS rates for 5 and 10 years were 92.0% and 79.0%, respectively, and in the 12-month group, 85.5% and 65.3% were (HR -0.55, 95% CI 0.37-0.83; P-0.004) In the effective population, 15 patients who were not diagnosed with GIST in the central pathology examination and 24 patients with intra-abdominal metastine removed from surgery were excluded, with 10-year OS rates of 81.6% and 66.8% in the 36-month and 12-month groups, respectively (HR-0.50, 95% CI 0.32-0.80; P-0.003) No new adverse reaction events were detected conclusion: 3 years of imatinib treatment compared to one year of treatment, the first 10 years after surgery can prevent about 50% of deaths Author: Network Source: network
This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only.
This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of
the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed
description of the concern or complaint, to
service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content
will be removed immediately.