Key Laboratory of Carcinogenesis & Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
Future Oncol. 2012 May;8(5):617-24. doi: 10.2217/fon.12.29.
To assess the efficacy and safety of sunitinib in Chinese patients with imatinib-resistant or -intolerant gastrointestinal stromal tumors (GISTs), and evaluate the impact of genotype on sunitinib efficacy.
MATERIALS & METHODS: In a single-arm retrospective study, 55 patients with recurrent or metastatic GISTs who were resistant or intolerant to prior imatinib treatment received sunitinib for at least one treatment cycle.
The median progression-free survival was 35 weeks (95% CI: 24.6-45.4) in patients who received sunitinib 37.5 mg/day as a continuous daily dose versus 30 weeks (95% CI: 12.8-47.2) in those who received sunitinib 50 mg/day as a 4-weeks-on, 2-weeks-off (4/2) schedule (p = 0.707). The median overall survival of all patients was 86 weeks (95% CI: 75.0-97.0). Patients with KIT exon 9 mutations had a significantly longer progression-free survival compared with those with KIT exon 11 mutations and patients with wild-type GISTs (p = 0.022). Sunitinib therapy was well tolerated, with most adverse events rated as grade 1 or 2 in severity. The sunitinib 37.5 mg/day continuous daily dose schedule was better tolerated by Chinese GIST patients than the 50 mg/day 4/2 schedule.
Sunitinib was effective and well tolerated in Chinese patients with imatinib-resistant or -intolerant GISTs. Patients with KIT exon 9 mutations showed the best efficacy. A 37.5 mg/day continuous daily dose sunitinib dosing schedule appears to be the optimal choice for Chinese patients due to a decreased incidence of adverse events.
评估舒尼替尼治疗伊马替尼耐药或不耐受的胃肠间质瘤(GIST)中国患者的疗效和安全性,并评估基因型对舒尼替尼疗效的影响。
在一项单臂回顾性研究中,55 例先前伊马替尼治疗耐药或不耐受的复发性或转移性 GIST 患者接受舒尼替尼治疗,至少接受一个治疗周期。
接受舒尼替尼 37.5mg/天连续每日剂量治疗的患者中位无进展生存期为 35 周(95%CI:24.6-45.4),而接受舒尼替尼 50mg/天 4/2 方案(每 4 周治疗 2 周停药)治疗的患者中位无进展生存期为 30 周(95%CI:12.8-47.2)(p=0.707)。所有患者的中位总生存期为 86 周(95%CI:75.0-97.0)。与 KIT 外显子 11 突变患者和野生型 GIST 患者相比,KIT 外显子 9 突变患者的无进展生存期显著延长(p=0.022)。舒尼替尼治疗耐受性良好,大多数不良反应严重程度为 1 级或 2 级。舒尼替尼 37.5mg/天连续每日剂量方案在中国 GIST 患者中的耐受性优于 50mg/天 4/2 方案。
舒尼替尼治疗伊马替尼耐药或不耐受的中国 GIST 患者有效且耐受性良好。KIT 外显子 9 突变患者疗效最佳。舒尼替尼 37.5mg/天连续每日剂量方案似乎是中国患者的最佳选择,因为不良反应发生率降低。