伊马替尼（格列卫）与尼日利亚人的胃肠道间质瘤

Imatinib (Glivec) and gastrointestinal stromal tumours in Nigerians.

作者信息

Durosinmi M A, Salawu L, Lawal O O, Ojo O S, Alatishe O I, Oyekunle A A, Bolarinwa R A, Adisa A O, Badmos K, Anomneze E E, Ayansanwo A O

出版信息

Afr J Med Med Sci. 2013 Dec;42(4):325-32.

PMID:24839736

Abstract

BACKGROUND

To assess the response and the impact on the overall survival (OS) on c-KIT-positive (CD117+) gastrointestinal stromal tumours (GISTs) patients treated with imatinib mesylate.

METHODS

Between July 2003 and December 2012, consenting patients with advanced c-kit-positive GISTs were enrolled to receive imatinib mesylate therapy at a dose of 400mg - 800mg daily, supplied gratis by Novartis Pharma (Basel, Switzerland) under its GIPAP initiative. Disease severity was based on tumour site, size and mitotic index at diagnosis. Clinical features together with drug toxicity, haematological and biochemical parameters were monitored. Overall survival (OS) reviewed at 12 months intervals over 5 years was computed using Kaplan-Meier

RESULTS

There were 27 patients in all (17 males and 10 females with a median age of 52 years (range 26 - 83). Twenty three patients, 15 males and 8 females that have been followed up for at least 6 months were evaluated, aged 26-83 years (median = 56). There were 17 (73.9%) gastric tumours and 6 extragastric including 3 cases of peritoneum and 1 each of small gut, colon and rectum. At diagnosis, 21 (91.3%) cases were high risk, and 1 each fell into the intermediate and low risks, respectively. Ten patients (43.4%) including 5 with metastases presented with unresectable lesions. Five patients (21.7%) had complete tumour resection, 5 (3 with metastases) had partial resections and 3 others with non-bulky, nonmetastatic diseases underwent no surgery. Imatinib was used as the primary therapy for all patients, except the 5 patients that underwent complete tumour resection. Nine (39.1%) patients were lost to disease progression with a median survival of 16.7 +/- 10.7 (+/- SE) (95% CI = 0-37.6) months. The overall survival at 2 years for all patients was 71.9%, which dropped to 65.9% at 4 years.

CONCLUSIONS

Although a small number of GISTs, imatinib induced an extended remission in patients with advanced disease, most of whom would have been dead within a few months of diagnosis.

摘要

背景

评估甲磺酸伊马替尼治疗c-KIT阳性（CD117+）胃肠道间质瘤（GIST）患者的疗效及对总生存期（OS）的影响。

方法

2003年7月至2012年12月期间，纳入同意接受治疗的晚期c-KIT阳性GIST患者，接受甲磺酸伊马替尼治疗，剂量为每日400mg - 800mg，由诺华制药（瑞士巴塞尔）根据其全球患者援助计划（GIPAP）免费提供。疾病严重程度基于诊断时的肿瘤部位、大小和有丝分裂指数。监测临床特征以及药物毒性、血液学和生化参数。使用Kaplan-Meier法计算5年内每隔12个月复查的总生存期（OS）。

结果

共有27例患者（17例男性和10例女性，中位年龄52岁（范围26 - 83岁））。对23例患者（15例男性和8例女性）进行了评估，这些患者至少随访了6个月，年龄在26 - 83岁之间（中位年龄 = 56岁）。有17例（73.9%）胃肿瘤，6例胃外肿瘤，包括3例腹膜肿瘤以及小肠、结肠和直肠各1例。诊断时，21例（91.3%）病例为高危，分别有1例为中危和低危。10例患者（43.4%）包括5例有转移的患者表现为不可切除病变。5例患者（21.7%）进行了肿瘤完全切除，5例（3例有转移）进行了部分切除，另外3例非大块、无转移疾病的患者未接受手术。除5例进行了肿瘤完全切除的患者外，所有患者均将伊马替尼作为主要治疗。9例（39.1%）患者因疾病进展失访中位生存期为16.7 +/- 10.7（+/-标准误）（95%可信区间 = 0 - 37.6）个月。所有患者2年总生存率为71.9%，4年时降至65.9%。