The current status of and prospects in research regarding gastrointestinal stromal tumors in China

Jian Li, Lin Shen, Jian Li, Lin Shen

Abstract

China still lacks statistical data regarding the incidence of gastrointestinal stromal tumors (GISTs). Data from 3 regions have demonstrated that the incidence of GISTs in China is similar to that in the United States. Furthermore, no significant differences between both nations with regard to epidemiological characteristics and genotyping of GISTs have been reported. Chinese physicians are demonstrating an increased interest in studies regarding GISTs. Currently, to the authors' knowledge, China publishes the most research articles regarding GIST annually worldwide. Despite the paucity of relevant research regarding the clinical practices for GISTs, a series of studies performed by Chinese physicians in the fields of recurrence risk classification, laparoscopic surgery, and adjuvant therapy have contributed to the diagnosis and treatment of GISTs. The lack of innovative drugs, slow approval of new drugs, and insufficient research funds have limited further advancements in GIST-related research in China. In recent years, increased investment in scientific research has allowed for these advancements to be made by creating conditions for Chinese physicians to conduct high-level clinical research. Chinese researchers hope to further shorten the gap between China and the rest of the world in the field of GIST research within a relatively short period. The purpose of the current review article was to present the most updated information regarding the diagnosis and treatment of GISTs in Chinese medical practice and to suggest prospective research in this field.

Keywords: China; clinical research; epidemiology; gastrointestinal stromal tumor (GIST); genotype; innovative drugs.

© 2020 American Cancer Society.

References

    1. Ye Y, Liang Y. Immunohistochemical study on 101 cases of gastrointestinal stromal tumors-an attempt to evaluate the histogenesis [in Chinese]. Chinese J Cancer. 1991;10:390-394.
    1. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577-580.
    1. Ding G, Yang J, Cheng S, et al. A rare case of rapid growth of exophytic gastrointestinal stromal tumor of the stomach. Dig Dis Sci. 2005;50:820-823.
    1. Siddiq K, Akbar HF, Khan M, Siddiqui AA, Nusrat S, Blay JY. The 100 most influential papers and recent trends in the field of gastrointestinal stromal tumours: a bibliometric analysis. Cureus. 2018;10:e2311. doi:10.7759/cureus.2311
    1. Blay JY, Shen L, Kang YK, et al. Nilotinib versus imatinib as first-line therapy for patients with unresectable or metastatic gastrointestinal stromal tumours (ENESTg1): a randomized phase 3 trial. Lancet Oncol. 2015;16:550-560.
    1. Demetri GD, Reichardt P, Kang YK, et al; GRID study investigators. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381:295-302. doi:10.1016/S0140-6736(12)61857-1
    1. Patel N, Benipal B. Incidence of gastrointestinal stromal tumors in the United States from 2001-2015: a United States cancer statistics analysis of 50 states. Cureus. 2019;11:e4120. doi:10.7759/cureus.4120
    1. Wang ZH, Liang XB, Wang Y, Ma GL, Qu YQ, Tian XW. Epidemiology survey of gastrointestinal stromal tumor in Shanxi Province in 2011 [in Chinese]. Zhonghua Yi Xue Za Zhi. 2013;93:2541-2544.
    1. Lv M, Wu C, Zheng Y, Zhao N. Incidence and survival analysis of gastrointestinal stromal tumors in Shanghai: a population-based study from 2001 to 2010. Gastroenterol Res Pract. 2014;2014:834136.
    1. Hung GY, Horng JL, Chen PC, et al. Incidence of soft tissue sarcoma in Taiwan: a nationwide population-based study (2007-2013). Cancer Epidemiol. 2019;60:185-192. doi:10.1016/j.canep.2019.04.007
    1. Liu X, Qiu H, Zhang P, et al; China Gastrointestinal Stromal Tumor Study Group (CN-GIST). Prognostic factors of primary gastrointestinal stromal tumors: a cohort study based on high-volume centers. Chin J Cancer Res. 2018;30:61-71. doi:10.21147/j.issn.1000-9604.2018.01.07
    1. Li Y, Gao J, Tian Y, Li J, Shen L. Mutation profiles of c-kit/PDGFRα and its associations with clinicopathological characteristics in Chinese gastrointestinal stromal tumors: analysis of 827 cases [in Chinese]. Zhonghua Wei Chang Wai Ke Za Zhi. 2015;18:332-337.
    1. Wang M, Xu J, Zhao W, et al. Prognostic value of mutational characteristics in gastrointestinal stromal tumors: a single-center experience in 275 cases. Med Oncol. 2014;31:819. doi:10.1007/s12032-013-0819-x
    1. Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813-3825.
    1. Hou YY, Lu SH, Zhou Y, et al. Stage and histological grade of gastrointestinal stromal tumors based on a new approach are strongly associated with clinical behaviors. Mod Pathol. 2009;22:556-569. doi:10.1038/modpathol.2009.11
    1. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39:1411-1419. doi:10.1016/j.humpath.2008.06.025
    1. Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70-83.
    1. Liu X, Qiu H, Zhang P, et al; China Gastrointestinal Stromal Tumor Study Group (CN-GIST). Ki-67 labeling index may be a promising indicator to identify “very high-risk” gastrointestinal stromal tumor: a multicenter retrospective study of 1022 patients. Hum Pathol. 2018;74:17-24. doi:10.1016/j.humpath.2017.09.003
    1. Zheng J, Li R, Qiu H, et al. Tumor necrosis and >20 mitoses per 50 high-power fields can distinguish ‘very high-risk’ and ‘highest-risk’ within ‘high-risk’ gastric gastrointestinal stromal tumor. Future Oncol. 2018;14:621-629. doi:10.2217/fon-2017-0509
    1. Inaba CS, Dosch A, Koh CY, et al. Laparoscopic versus open resection of gastrointestinal stromal tumors: survival outcomes from the NCDB. Surg Endosc. 2019;33:923-932. doi:10.1007/s00464-018-6393-8
    1. Cao F, Li A, Li J, Fang YU, Li F. Feasibility and safety of laparoscopic resection for gastric GISTs larger than 5 cm: results from a prospective study. Oncol Lett. 2015;10:2081-2086.
    1. Huang CM, Chen QF, Lin JX, et al. Can laparoscopic surgery be applied in gastric gastrointestinal stromal tumors located in unfavorable sites?: A study based on the NCCN guidelines. Medicine (Baltimore). 2017;96:e6535. doi:10.1097/MD.0000000000006535
    1. Du CY, Zhou Y, Song C, et al. Is there a role of surgery in patients with recurrent or metastatic gastrointestinal stromal tumours responding to imatinib: a prospective randomised trial in China. Eur J Cancer. 2014;50:1772-1778. doi:10.1016/j.ejca.2014.03.280
    1. Zhang X, Zhou Y, Wu X, et al. Cytoreductive surgery for metastatic gastrointestinal stromal tumors followed by sunitinib compared to followed by imatinib-a multi-center cohort study. Eur J Surg Oncol. 2019;45:318-323. doi:10.1016/j.ejso.2018.08.001
    1. Li J, Gong JF, Wu AW, Shen L. Post-operative imatinib in patients with intermediate or high risk gastrointestinal stromal tumor. Eur J Surg Oncol. 2011;37:319-324. doi:10.1016/j.ejso.2011.01.005
    1. Joensuu H, Eriksson M, Sundby Hall K, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA. 2012;307:1265-1272. doi:10.1001/jama.2012.347
    1. Lin JX, Chen QF, Zheng CH, et al. Is 3-years duration of adjuvant imatinib mesylate treatment sufficient for patients with high-risk gastrointestinal stromal tumor? A study based on long-term follow-up. J Cancer Res Clin Oncol. 2017;143:727-734. doi:10.1007/s00432-016-2334-x
    1. Fu Y, Hao H, Guo L, et al. Retrospective analysis of 85 cases of intermediate-risk gastrointestinal stromal tumor. Oncotarget. 2017;8:10136-10144. doi:10.18632/oncotarget.14359
    1. Wu X, Li J, Xu W, et al. Postoperative imatinib in patients with intermediate risk gastrointestinal stromal tumor. Future Oncol. 2018;14:1721-1729. doi:10.2217/fon-2017-0691
    1. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: soft tissue sarcoma. Version 2.2019. Accessed December 10, 2019.
    1. Casali PG, Abecassis N, Bauer S, et al; ESMO Guidelines Committee and EURACAN. Gastrointestinal stromal tumours: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(suppl 4):iv68-iv78. doi:10.1093/annonc/mdy095
    1. Li J, Ye Y, Wang J, et al;Chinese Society of Clinical Oncology Csco Expert Committee On Gastrointestinal Stromal Tumor. Chinese consensus guidelines for diagnosis and management of gastrointestinal stromal tumor. Chin J Cancer Res. 2017;29:281-293. doi:10.21147/j.issn.1000-9604.2017.04.01
    1. Dematteo RP, Ballman KV, Antonescu CR, et al; American College of Surgeons Oncology Group (ACOSOG) Intergroup Adjuvant GIST Study Team. Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet. 2009;373:1097-1104. doi:10.1016/S0140-6736(09)60500-6
    1. Li J, Gong JF, Li J, Gao J, Sun NP, Shen L. Efficacy of imatinib dose escalation in Chinese gastrointestinal stromal tumor patients. World J Gastroenterol. 2012;18:698-703. doi:10.3748/wjg.v18.i7.698
    1. Li J, Gao J, Hong J, Shen L. Efficacy and safety of sunitinib in Chinese patients with imatinib-resistant or -intolerant gastrointestinal stromal tumors. Future Oncol. 2012;8:617-624. doi:10.2217/fon.12.29
    1. Li N, Huang HY, Wu DW, et al. Changes in clinical trials of cancer drugs in mainland China over the decade 2009-18: a systematic review. Lancet Oncol. 2019;20:e619-e626. doi:10.1016/S1470-2045(19)30491-7

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