JAMA ONCOL:胃肠道间质瘤患者接受5年伊马替尼辅助治疗的有效性和耐受性

2018-11-11 MedSci MedSci原创

与接受1年治疗的患者相比,接受3年伊马替尼辅助治疗的高风险原发性胃肠道间质瘤(GIST)患者的复发率降低且总生存率升高。更长治疗时间的影响尚不清楚。JAMA ONCOL近期发表了一篇文章,研究原发性GIST患者接受5年的伊马替尼辅助治疗是否可以耐受及有效性。

与接受1年治疗的患者相比,接受3年伊马替尼辅助治疗的高风险原发性肠道间质瘤(GIST)患者的复发率降低且总生存率升高。更长治疗时间的影响尚不清楚。JAMA ONCOL近期发表了一篇文章,研究原发性GIST患者接受5年的伊马替尼辅助治疗是否可以耐受及有效性。

临床试验纳入在21个美国医院中接受了完全切除并具有中度或高复发风险的GIST患者(表达KIT),中或高复发风险标准为大于等于2cm的原发GIST,非来源的 GIST大于等于5cm。患者口服伊马替尼5年,每日400毫克,直至出现疾病进展或不可耐受而停止治疗。

研究的主要终点是无复发生存期(RFS),次要终点是总生存期。研究共纳入91名患者,48名为男性,中位年龄为60岁。中位肿瘤大小为6.5厘米。中位治疗时间为55.1个月; 46名患者(51%)完成了5年的伊马替尼治疗。5年RFS为90%,总生存率为95%。7例患者出现复发:1例患者在接受伊马替尼治疗时复发并死亡; 6例在停止伊马替尼治疗后出现疾病复发。另外两例死亡与治疗或肿瘤进展无关。45名患者(49%)提前停止治疗。所有91例患者均出现至少1种不良反应,17例患者(19%)出现3级或4级不良反应。

文章最后认为,原发性GIST患者切除后接受5年伊马替尼治疗,没有伊马替尼敏感突变患者在治疗期间出现疾病复发。出现疾病复发的患者在停止伊马替尼治疗后2年内复发。大约一半的患者提前停止治疗。

原始出处:

Chandrajit P. Raut, N. Joseph Espat, et al. Efficacy and Tolerability of 5-Year Adjuvant Imatinib Treatment for Patients With Resected Intermediate- or High-Risk Primary Gastrointestinal Stromal Tumor. JAMA Oncol. November 1 2018 doi: 10.1001/jamaoncol.2018.4060

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