title: Sunitinib for patients with locally advanced or distantly metastatic dermatofibrosarcoma protuberans but resistant to imatinib.
abstract: OBJECTIVE
  This study evaluated the efficacy and adverse effects of Imatinib therapy to advanced Dermatofibrosarcoma protuberan (DFSP) and Sunitinib therapy to advanced Dermatofibrosarcoma protuberan (DFSP) after Imatinib resistance.
  
  
  METHODS
  We analyzed the efficacy, adverse effects and survival of 95 patients with locally advanced or metastatic DFSP treated by Imatinib between January 2003 and December 2009, and also analyzed the efficacy and adverse effects of 30 patients after Imatinib failure between January 2008 and December 2011.
  
  
  RESULTS
  In all 95 patients treated by Imatinib, 16 had complete response (CR, 16.8%), 44 had partial response (PR, 46.3%), 23 had stable disease (SD, 24.2%) and 12 had progressive disease (PD, 12.6%). The DCR (CR+PR+SD) was 87.4%. The median PFS was 23 months and the OS was 40 months. For 30 patients had Sunitinib treatment after Imatinib failure, 2 had CR (6.7%), 10 had PR (33.3%), 12 had SD (40%) and 6 had PD (20%). The disease control rate (DCR=CR+PR+SD) was 73.3%. The progression free survival (PFS) of CR and PR patients were 22 months and 20 months respectively. The PFS of 12 SD was 18 months, and overall survival (OS) was 28 months. And the median PFS and OS of all 30 patients were 19 and 27 months respectively after Sunitinib treatment. Most of the Imatinib-induced adverse effects are of grade 1-2, including nausea, water retention/edema, fatigue, etc.
  
  
  CONCLUSIONS
  Imatinib has been proven to be effective and well-tolerated in the treatment of locally advanced or inoperable patients with DFSP. After Imatinib failure, Sunitinib therapy showed good clinical efficacy and tolerated adverse effects as a new treatment option for such patients.
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Huanrong
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Xiaosong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Du
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital Beijing 100048, China.
authors.forename: Yitao
authors.initials: Y
authors.lastname: Huang
keywords: Dermatofibrosarcoma protuberan; Sunitinib; efficacy; imatinib; resistance