Long-term outcome of dasatinib first-line treatment in gastrointestinal stromal tumor: A multicenter, 2-stage phase 2 trial (Swiss Group for Clinical Cancer Research 56/07).

Détails

ID Serval
serval:BIB_423A807460D5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Long-term outcome of dasatinib first-line treatment in gastrointestinal stromal tumor: A multicenter, 2-stage phase 2 trial (Swiss Group for Clinical Cancer Research 56/07).
Périodique
Cancer
Auteur(s)
Montemurro M., Cioffi A., Dômont J., Rutkowski P., Roth A.D., von Moos R., Inauen R., Toulmonde M., Burkhard R.O., Knuesli C., Bauer S., Cassier P., Schwarb H., Le Cesne A., Koeberle D., Bärtschi D., Dietrich D., Biaggi C., Prior J., Leyvraz S.
ISSN
1097-0142 (Electronic)
ISSN-L
0008-543X
Statut éditorial
Publié
Date de publication
01/04/2018
Peer-reviewed
Oui
Volume
124
Numéro
7
Pages
1449-1454
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Tyrosine kinase inhibitors (TKIs) have improved the outcome of patients with gastrointestinal stromal tumors (GISTs), but most patients eventually develop resistance and progress. Dasatinib is a potent inhibitor of BCR-ABL, KIT, and SRC family kinases as well as imatinib-resistant cells. In GISTs, response evaluation is routinely done using computed tomography (CT) and javax.xml.bind.JAXBElement@2891d1a9 F-fluorodeoxyglucose positron emission tomography coupled to CT (FDG-PET/CT) for early response assessment and outcome prediction.
This was a 2-stage, phase 2 trial investigating dasatinib 2 × 70 mg per day in patients with histologically proven, TKI-naïve, FDG-PET/CT-positive GIST. The primary endpoint was FDG-PET/CT response.
Of 52 planned patients, 47 were enrolled from January 2008 to November 2011, when the trial was terminated because of slow accrual. In total, 42 patients were eligible. The median patient age was 61 years, 24 patients were men, and 18 were women. Performance status was 0 in 29 patients and 1 in 13 patients. The median follow-up was 67.2 months. Patients went off trial for elective surgery (n = 8), after 26 cycles as per protocol (n = 5), for disease progression (n = 14), for toxicity (n = 7), and for other reasons (n = 5); and 3 patients died (2 had discontinued drug and 1 was still receiving drug). Toxicity was grade 4 in 5% and grade 3 in 48% of patients and was most often gastrointestinal or pulmonary. Dose was interrupted or reduced in 25% of cycles. The FDG-PET/CT response rate (complete plus partial responses) at 4 weeks was 74% (95% confidence interval, 56%-85%; 14 patients had a complete response, 17 had a partial response, 6 had stable disease, 3 had progressive disease, and 2 were not evaluable). The median progression-free survival was 13.6 months, and the median overall survival was not reached.
Dasatinib produced high metabolic response rates in TKI-naive patients with FDG-PET/CT-positive GIST. Cancer 2018;124:1449-54. © 2018 American Cancer Society.

Mots-clé
18F-fluorodeoxyglucose-positron emission tomography (FDG-PET), FDG-PET, PET, dasatinib, gastrointestinal stromal tumor (GIST), imatinib, positron emission tomography (PET), sunitinib, tyrosine kinase inhibitor (TKI)
Pubmed
Web of science
Création de la notice
22/01/2018 10:32
Dernière modification de la notice
18/04/2018 6:26
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