Efficacy evaluation of imatinib treatment in patients with gastrointestinal stromal tumors: a meta-analysis.
OBJECTIVE
To perform a meta-analysis to derive a more precise estimation of imatinib treatment for different genotypes of gastrointestinal stromal tumors (GIST).


METHODS
Studies were identified by searching PubMed and Embase. Inclusive criteria were patients with exon 9-mutant, exon 11-mutant or wide type (WT) GIST, receiving chemotherapy of imatinib for clinical trial, and efficacy evaluation was cumulative response (CR) including complete response and partial response. The odds ratios (OR) for CR in stem cell factor receptor (KIT) mutation patients vs WT genotype patients, KIT exon 11-mutant genotype patients vs KIT exon 9-mutant genotype patients and KIT exon 9-mutant genotype patients vs WT genotype patients were calculated with 95% confidence interval (CI) for each study as an estimation of the efficacy of imatinib.


RESULTS
Five studies including 927 patients were involved in this meta-analysis. The overall OR (KIT group vs WT group) was 3.34 (95% CI: 2.30-4.86, P < 0.00001, P(heterogeneity) = 0.04). The overall OR in KIT exon 11 group vs KIT exon 9 group was 3.29 (95% CI: 2.17-5.00, P < 0.00001, P(heterogeneity) = 0.33). The overall OR in KIT exon 9 group vs WT group was 1.23 (95% CI: 0.73-2.10, P = 0.44, P(heterogeneity) = 0.42).


CONCLUSIONS
Most patients with different genotypes of GIST and KIT exon 11-mutant will benefit from the individualized treatment of imatinib.
Chen
Ping
P
Department of Gastrointestinal Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China. chen86ky@126.com
Zong
Liang
L
Zhao
Wei
W
Shi
Lei
L
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D005091:Exons / Q000235:genetics; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000235:genetics; D005838:Genotype; D006801:Humans; D000068877:Imatinib Mesylate; D009154:Mutation / Q000235:genetics; D010879:Piperazines / Q000627:therapeutic use*; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D019009:Proto-Oncogene Proteins c-kit
Arch Surg. 2001 Apr;136(4):383-9
11296107
Curr Treat Options Oncol. 2002 Dec;3(6):489-96
12392638
J Clin Oncol. 2008 Nov 20;26(33):5360-7
18955451
J Clin Oncol. 2004 Sep 15;22(18):3813-25
15365079
Hum Pathol. 2002 May;33(5):466-77
12094371
N Engl J Med. 2002 Aug 15;347(7):472-80
12181401
Science. 1998 Jan 23;279(5350):577-80
9438854
Lancet. 2004 Sep 25-Oct 1;364(9440):1127-34
15451219
Eur J Cancer. 2006 May;42(8):1093-103
16624552
Cancer Res. 2004 Sep 1;64(17):5913-9
15342366
J Cancer Res Clin Oncol. 2007 Sep;133(9):589-97
17458563
Eur J Surg Oncol. 2008 May;34(5):563-8
17532173
J Clin Oncol. 2003 Dec 1;21(23):4342-9
14645423
Ann Surg Oncol. 2007 Mar;14(3):1123-8
17195905
J Clin Oncol. 2005 Aug 10;23(23):5357-64
15928335
Clin Cancer Res. 2006 Mar 15;12(6):1743-9
16551858
Science. 2003 Jan 31;299(5607):708-10
12522257
J Clin Oncol. 2000 Sep 15;18(18):3211-20
10986053
J Clin Oncol. 2008 Feb 1;26(4):620-5
18235121
Gastroenterology. 2003 Sep;125(3):660-7
12949711
J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
10655437
J Clin Oncol. 2008 Feb 1;26(4):626-32
18235122
Gastroenterology. 2006 May;130(6):1573-81
16697720
Br J Surg. 2003 Mar;90(3):332-9
12594669