Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 21, 2012; 18(7): 698-703
Published online Feb 21, 2012. doi: 10.3748/wjg.v18.i7.698
Efficacy of imatinib dose escalation in Chinese gastrointestinal stromal tumor patients
Jian Li, Ji-Fang Gong, Jie Li, Jing Gao, Nai-Ping Sun, Lin Shen
Jian Li, Ji-Fang Gong, Jie Li, Jing Gao, Nai-Ping Sun, Lin Shen, Laboratory of Carcinogenesis and Translational Research for the Ministry of National Education, Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Li J helped collect data and wrote the manuscript; Li J and Gong JF helped collect data; Gao J and Sun NP analyzed kit/PDGFRA genotype; Shen L was in charge of the project and revised the manuscript.
Supported by Beijing Cancer Hospital Foundation, No. 08-17 and Novartis Oncology
Correspondence to: Lin Shen, Dr., Laboratory of Carcinogenesis and Translational Research for the Ministry of National Education, Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. lin100@medmail.com.cn
Telephone: +10-86-881906088 Fax: +10-86-88196561
Received: April 4, 2011
Revised: June 24, 2011
Accepted: July 1, 2011
Published online: February 21, 2012
Abstract

AIM: To investigate the efficacy and safety of imatinib dose escalation in Chinese patients with advanced gastrointestinal stromal tumor (GIST).

METHODS: Advanced GIST patients previously failing 400 mg imatinib treatment were enrolled in this study. Patients received imatinib with dose escalation to 600 mg/d, and further dose escalation to 800 mg/d if imatinib 600 mg/d failed. Progression-free survival, overall survival, clinical efficacy, c-kit/PDGFRA genotype and safety were evaluated.

RESULTS: 52 patients were enrolled in this study. For the 47 evaluable patients receiving imatinib (600 mg/d), the disease control rate was 40.4%, and the median progression-free survival for all patients was 17 wk (95% CI: 3.9-30.1). The median overall survival after dose escalation was 81 wk (95% CI: 36.2-125.8). Adverse events, mainly edema, fatigue, granulocytopenia and skin rash were tolerable. However, further dose escalation (800 mg/d) in 14 cases was ineffective, with disease progression and severe adverse events. Among 30 cases examined for gene mutations, patients with exon 9 mutations experienced a better progression-free survival of 47 wk.

CONCLUSION: Imatinib dose escalation to 600 mg/d is more appropriate for Chinese patients and may achieve further survival benefit.

Keywords: Gene mutation; Gastrointestinal stromal tumor; Imatinib; Increased dose