Zhao Zekun, Zhang Jie, Zhang Wenbing, Tan Siyuan, Wei Hao-Tang, You Jun, Guo Shanshan, Wang Jing, Chen Ping, Xu Yingying, Zong Liang
Department of General Surgery, Tongji Hospital, Medical School of Tongji University, Shanghai, PR China.
Department of General Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou, PR China.
Curr Probl Cancer. 2021 Jun;45(3):100705. doi: 10.1016/j.currproblcancer.2020.100705. Epub 2021 Jan 19.
Nilotinib has been used as a third-line drug for gastrointestinal stromal tumors (GISTs) after a failure of sunitinib. In this study, we aimed to evaluate the efficacy of nilotinib in different genomic subtypes of GISTs. We searched the English articles through EMBASE, Cochrane Library and PubMed Database regarding to the use of nilotinib on GISTs, which published up to February 15, 2019. Inclusion criteria were: GISTs patients received nilotinib in a clinical trial and had detailed genetic subtype records (such as KIT exon 9, KIT exon 11, or PDGFRA mutations, or wild-type). The clinical benefit rate was used to assess the efficacy of nilotinib. A total of 3 studies involving 218 GISTs were included in this meta-analysis. The overall OR (KIT group vs WT group) was 3.26 (95% CI: 1.14-9.28; P = 0.027, P = 0.613). The overall OR in KIT exon 11 group vs WT group was 5.30 (95% CI: 1.79-15.68; P = 0.003, P = 0.409). The overall OR in KIT exon 9 group vs WT group was 0.13 (95% CI: 0.02-0.86; P = 0.035, P = 0.229). The overall OR in KIT exon 11 group vs exon 9 group was 9.96 (95% CI: 0.39-254.66; P < 0.0001, P = 0.024). Different genotypes of GISTs showed different responses to nilotinib, and KIT exon 11-mutant GISTs mostly benefited from nilotinib, followed by KIT exon 9-mutant or WT one.
尼洛替尼已被用作舒尼替尼治疗失败后胃肠道间质瘤（GIST）的三线药物。在本研究中，我们旨在评估尼洛替尼在不同基因组亚型GIST中的疗效。我们通过EMBASE、Cochrane图书馆和PubMed数据库检索了截至2019年2月15日发表的关于尼洛替尼用于GIST的英文文章。纳入标准为：GIST患者在临床试验中接受了尼洛替尼治疗且有详细的基因亚型记录（如KIT外显子9、KIT外显子11或血小板衍生生长因子受体α（PDGFRA）突变，或野生型）。临床获益率用于评估尼洛替尼的疗效。本荟萃分析共纳入3项涉及218例GIST的研究。总体比值比（KIT组与野生型组）为3.26（95%可信区间：1.14 - 9.28；P = 0.027，P = 0.613）。KIT外显子11组与野生型组的总体比值比为5.30（95%可信区间：1.79 - 15.68；P = 0.003，P = 0.409）。KIT外显子9组与野生型组的总体比值比为0.13（95%可信区间：0.02 - 0.86；P = 0.035，P = 0.229）。KIT外显子11组与外显子9组的总体比值比为9.96（95%可信区间：0.39 - 254.66；P < 0.0001，P = 0.024）。不同基因型的GIST对尼洛替尼表现出不同反应，KIT外显子11突变型GIST大多从尼洛替尼中获益，其次是KIT外显子9突变型或野生型GIST。
