Clinical benefit of sunitinib in gastrointestinal stromal tumors with different exon 11 mutation genotypes

Future Oncol. 2017 Oct;13(23):2035-2043. doi: 10.2217/fon-2017-0252. Epub 2017 Jul 7.

Abstract

Aim: To assess the efficacy of second-line sunitinib therapy in gastrointestinal stromal tumor patients with different exon 11 mutation genotypes.

Patients & methods: Thirty eight of the 75 patients received imatinib (IM) dose escalation followed by sunitinib (IM escalation group), while 37 were switched to sunitinib directly after the failure of first-line IM treatment (sunitinib group). Progression-free survival and overall survival were compared.

Results: The median progression-free survival in the sunitinib group was significantly longer than in the IM escalation group (14 vs 4 months; p < 0.001), so was in patients with exon 11 deletions (16 vs 3 months; p < 0.001).

Conclusion: Patients who have an exon 11 deletion mutation are more likely to benefit from switching to sunitinib directly than from IM dose escalation.

Keywords: exon 11 deletion mutation; gastrointestinal stromal tumors; imatinib dose escalation; sunitinib.

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / therapeutic use*
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Combined Modality Therapy
  • Disease Progression
  • Drug Substitution
  • Exons*
  • Female
  • Gastrointestinal Stromal Tumors / drug therapy*
  • Gastrointestinal Stromal Tumors / genetics*
  • Gastrointestinal Stromal Tumors / mortality
  • Gastrointestinal Stromal Tumors / pathology
  • Genotype*
  • Humans
  • Indoles / administration & dosage
  • Indoles / adverse effects
  • Indoles / therapeutic use*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mutation*
  • Neoplasm Recurrence, Local
  • Prognosis
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects
  • Pyrroles / therapeutic use*
  • Sunitinib
  • Treatment Failure
  • Treatment Outcome

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Indoles
  • Pyrroles
  • Sunitinib