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舒尼替尼治疗伊马替尼耐药或不耐受的胃肠间质瘤中国患者的疗效和安全性。

Efficacy and safety of sunitinib in Chinese patients with imatinib-resistant or -intolerant gastrointestinal stromal tumors.

机构信息

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.

出版信息

Future Oncol. 2012 May;8(5):617-24. doi: 10.2217/fon.12.29.

Abstract

AIMS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

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。

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