在患有转移性胃肠道筋瘤的患者中,激酶突变和伊马替尼布反应
Michael C Heinrich1, Christopher L Corless1, George D Demetri1
1From the Oregon Health and Science University Cancer Institute, Oregon Health and Science University, and Portland Veterans Affairs Medical Center, Portland, OR; Dana-Farber Cancer Institute and Harvard Cancer Center, Boston, MA; Fox-Chase Cancer Center, Philadelphia, PA; University of Turku, Turku; University of Helsinki, Helsinki, Finland; and Novartis Oncology, Basel, Switzerland.
具有特定KIT突变的胃肠道 stromal 瘤 (GIST),特别是外显子11,对伊马替尼治疗有更好的反应. 了解这些突变有助于预测高级GIST患者的结果.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 药物基因组学 药物基因组学
背景情况:
- 大多数胃肠道 stromal 瘤 (GIST) 是由激活KIT或PDGFRA激酶突变驱动的.
- 这些突变代表了imatinib mesylate治疗在先进GIST中的关键治疗标.
- 特定的突变类型会影响意马替尼治疗的疗效.
研究的目的:
- 研究特定KIT和PDGFRA突变与晚期GIST患者对伊马替尼的临床反应之间的关系.
- 为了将突变状态与治疗结果相关联,包括反应率和存活率.
主要方法:
- 在第二阶段伊马替尼研究中,从127名患者的GIST样本中分析了KIT或PDGFRA突变.
- 确定了突变类型,并与临床结果相关联.
- 在实验室中评估了突变异构体对伊马替尼的敏感性.
主要成果:
- 在88.2%的GIST中发现了KIT的激活突变,在PDGFRA中发现了4.7%.
- 异构11中的KIT突变与高的部分响应率 (83.5%) 和改善的生存率有关.
- 具有KIT突变或没有可检测突变的瘤显示出显著较低的反应率和存活率.
结论:
- 激活KIT或PDGFRA突变在GIST中普遍存在,并预测对伊马替尼的反应.
- 特定的突变状态,特别是外11KIT突变,是临床反应和生存的强有力的预测指标.
- 在缺乏KIT突变的GISTs的一个子集中,PDGFRA突变可以解释imatinib敏感性.
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