Brief Article
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World J Gastroenterol. Apr 28, 2011; 17(16): 2113-2119
Published online Apr 28, 2011. doi: 10.3748/wjg.v17.i16.2113
Sunitinib for Taiwanese patients with gastrointestinal stromal tumor after imatinib treatment failure or intolerance
Yen-Yang Chen, Chun-Nan Yeh, Chi-Tung Cheng, Tsung-Wen Chen, Kun-Ming Rau, Yi-Yin Jan, Miin-Fu Chen
Yen-Yang Chen, Kun-Ming Rau, Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taoyuan 333, Taiwan, China
Chun-Nan Yeh, Chi-Tung Cheng, Tsung-Wen Chen, Yi-Yin Jan, Miin-Fu Chen, GIST team, Department of Surgery, Chang Gung Memorial Hospital and University, Taoyuan 333, Taiwan, China
Author contributions: Chen YY helped collect the data and wrote the manuscript; Yeh CN was in charge of this project and revised the manuscript; Cheng CT, Chen TW, Rau KM, Jan YY and Chen MF helped to review this paper.
Supported by Chang Gung Medical Research Program 380711 Grant to Dr. Yeh CN
Correspondence to: Chun-Nan Yeh, MD, GIST team, Department of Surgery, Chang Gung Memorial Hospital and University, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan 333, Taiwan, China.
Telephone: +886-3-3281200 Fax: +886-3-3285818
Received: November 8, 2010
Revised: January 3, 2011
Accepted: January 10, 2011
Published online: April 28, 2011

AIM: To report preliminary results of the efficacy and safety of sunitinib in the management of Taiwanese gastrointestinal stromal tumors (GIST) patients facing imatinib mesylate (IM) intolerance or failure.

METHODS: Between 2001 and May 2010, 199 Taiwanese patients with metastatic GIST were treated at Chang Gung Memorial Hospital. Among them, 23 (11.6%) patients receiving sunitinib were investigated.

RESULTS: Sixteen male and 7 female patients with a median age of 59 years (range: 24-83 years) received sunitinib. Twenty-two GIST patients changed to sunitinib because of IM failure and 1 because of intolerance. The median duration of sunitinib administration was 6.0 mo (range: 2-29 mo). The clinical benefit was 65.2% [2 complete response (CR), 4 partial response (PR), and 9 stationary disease (SD); 15/23]. In 12 patients harboring mutations of the kit gene at exon 11, the clinical benefit rate (CR, PR, and SD) was 75.0% and 6 patients with tumors containing kit exon 9 mutations had a clinical benefit of 50.0% (not significant, P = 0.344). The progression free survival (PFS) and overall survival (OS) did not differ between patients whose GISTs had wild type, KIT exon 9, or KIT exon 11 mutations. Hand-foot syndrome was the most common cause of grade III adverse effect (26.1%), followed by anemia (17.4%), and neutropenia (13.0%). During the median 7.5-mo follow-up after sunitinib use, the median PFS and OS of these 23 GIST patients after sunitinib treatment were 8.4 and 14.1 mo, respectively.

CONCLUSION: Sunitinib appears to be an effective treatment for Taiwanese with IM-resistant/intolerant GISTs and induced a sustained clinical benefit in more than 50% of Taiwanese advanced GIST patients.

Keywords: Suintinib, Gastrointestinal stromal tumors, Imaitinib, Failure or intolerance