The Impact Of Different Durations Of The Gleevec Therapy On Survival Time Of Advanced Gastrointestinal Stromal Tumor

Objective:This study aims to explore the impact of different duration of the Gleevec therapy on survival time and survival rate of advanced gastrointestinal stromal tumor.Methods:Patients from Shanxi Province incorporated into “Gleevec International Patient Assistance Program(GIPAP)” with unresectable or metastatic/recurrent GIST received Gleevec’s molecular targeted therapy were recruited, followed and retrospectively studied.Endpoints were progression-free survival(PFS)and overall survival(OS).All patients were divided into 4 groups according to the duration(T) of Gleevec therapy.Group A(76/158) : T≤ 12 months;Group B(37/158) : 12 < T ≤24 months;Group C(21/158) :24 < T≤ 36 months;Group D(24/158) : T > 36 months. Comparing with median progression-free survival(m PFS),median overall survival(m OS) and 1, 3, 5 years progression-free survival rates of 4 groups patients.Applying Kaplan–Meier method for survival analysis.Applying Log-rank test to compare survival rate.Results:A total of 158 patients with adanced GIST were enrolled in this retrospective clinical trial between May 2006, and April 2015. Of the total 158 patients, 98(62.0%) were men and 60(38.0%) were women with a mean age of 59 years(range:17-86). By November 30, 2015, after a median follow-up of 25 months(1–112months),48 patients continued Gleevec therapy,110 patients discontinued therapy. Of thetotal 158 patients: complete response(CR) 6 cases(3.8%), partial response(PR) 51 cases(32.3%), stable disease(SD) 18 cases(11.4%), and disease progression(PD) 13 cases(8.2%), death because GIST disease progression 70 cases(44.3%), disease control rate(CR+PR+SD) was 47.5%.The median progression free survival(m PFS) was 42 months and the median overall survival(m OS)was 52 months.A,B,C,D 4 groups’ median progression free survival(m PFS) were 18,40,59 and 83 months(P<0.01), respectively.A,B,C,D 4groups’ 1, 3, 5-year progression-free survival rates were:A group:55.3%,10.5%,3.9%,B group:94.6%,32.4%,16.2%,C group:100%,52.4%,19.0%,D group:100%、100%、54.2%,respectively;4 groups’ median overall survival(m OS) were 19,43,59 and NA months,respectively(P<0.01).4 groups’ 1, 3, 5-year overall survival rates were:A group:60.5%,14.5%,6.6%,B group:100%,37.8%,21.6%,C group:100%,57.1%,19.0%,D group:100%,100%,58.3%,respectively.Conclusion:The duration of the Gleevec therapy of Chinese people with advanced GIST and patients’ PFS,OS and 1, 3, 5-year survival rate existed a significant correlation.The PFS,OS and 1, 3, 5-year survival rate of patients who had received Gleevec therapy over 3years were superior to patients with less than 3 years. Continuous Gleevec therapy can delay time to disease progression.