Outcome of Patients with Platelet-Derived Growth Factor Receptor Alpha-Mutated Gastrointestinal Stromal Tumors in the Tyrosine Kinase Inhibitor Era

PA Cassier, E Fumagalli, P Rutkowski, P Schoffski, M Glabbeke, M Debiec-Rychter, JF Emile, F Duffaud, J Martin-Broto, B Landi, A Adenis, F Bertucci, E Bompas, O Bouche, S Leyvraz, I Judson, Jaap Verweij, P Casali, JY Blay, P Hohenberger

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Abstract

Purpose: Platelet-derived growth factor receptor-alpha (PDGFRA) mutations are found in approximately 5% to 7% of advanced gastrointestinal stromal tumors (GIST). We sought to extensively assess the activity of imatinib in this subgroup. Experimental Design: We conducted an international survey among GIST referral centers to collect clinical data on patients with advanced PDGFRA-mutant GISTs treated with imatinib for advanced disease. Results: Fifty-eight patients were included, 34 were male (59%), and median age at treatment initiation was 61 (range, 19-83) years. The primary tumor was gastric in 40 cases (69%). Thirty-two patients (55%) had PDGFRA-D842V substitutions whereas 17 (29%) had mutations affecting other codons of exon 18, and nine patients (16%) had mutation in other exons. Fifty-seven patients were evaluable for response, two (4%) had a complete response, eight (14%) had a partial response, and 23 (40%) had stabl Conclusions: This study is the largest reported to date on patients with advanced PDGFRA-mutant GISTs treated with imatinib. Our data confirm that imatinib has little efficacy in the subgroup of patients with D842V substitution in exon 18, whereas other mutations appear to be sensitive to imatinib. Clin Cancer Res; 18(16); 4458-64. (C)2012 AACR.
Original languageUndefined/Unknown
Pages (from-to)4458-4464
Number of pages7
JournalClinical Cancer Research
Volume18
Issue number16
DOIs
Publication statusPublished - 2012

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