To Compare the Efficacy of Surgery Followed by Sunitinib With Surgery Followed by Imatinib in GIST Patients With Progression on Imatinib.
2018年2月28日 更新者：Shen Lin、Peking University
A Retrospective Cohort Study
To compare the efficacy of surgery followed by sunitinib with surgery followed by imatinib in GIST patients with progression on imatinib;To investigate the optimal therapy after surgery in GIST patients with focal or multifocal progression in imatinib
研究概览
详细说明
Primary Endpoint: To evaluate the progression free survival of the patients with progression receiving surgery followed by sunitinib therapy comparing with surgery followed by imatinib Secondary Endpoint：To evaluate the overall survival of the patients with progression receiving surgery followed by sunitinib therapy comparing with surgery followed by imatinib the relationship of c-kit secondary mutation and progression free survival of surgery followed by TKI therapy the safety and tolerability of the two therapy.
Statistics:All the statistical analysis is performed using SPSS version 20.0 (IBM corporation, United States). Pearson's chi-squared test was used to compare categorical variables. PFS and OS analyses were estimated with Kaplan-Meier method and log-rank test and multivariable analyses were performed to assess survival difference. A two sided p-value of <0.05 was considered statistically significant.
研究类型
观察性的
注册 (预期的)
60
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Beijing
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Beijing、Beijing、中国、100142
- 招聘中
- Beijing Cancer Hospital
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接触：
- Jian Li, MD
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
取样方法
概率样本
研究人群
Test group is imatinib 400 mg/day or higher dose treatment failure and satisfactory reduction of tumor surgery patients with advanced gastrointestinal stromal tumor, patients must meet all the inclusion criteria and exclusion criteria to enter test.
描述
Inclusion Criteria:
- .Histopathological diagnosis of metastatic GIST.
- . After the treatment of imatinib, imatinib 400mg/day after treatment, the tumor generalized.
- . Patients with generalized progress were satisfied with tumor reduction after imatinib resistance for various reasons.
- at least 1 month after surgery for imatinib treatment or sunitinib treatment.
- at least one imaging assessment was received after surgery.
- . Complete clinical data and follow-up data.
Exclusion Criteria:
- . Before operation, he was treated with sunitinib
- . Patients receiving tumor reduction were not satisfied with the standard of the reduction of tumor.
- . The treatment of imatinib or sunitinib after surgery was less than 1 month.
- . Incomplete clinical data or follow-up data.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
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Arm A
Imatinib 400 mg/day or 600mg/day, and within 6 weeks after surgery, continuous treatment was not tolerated until tumor progression, recurrence or adverse reactions were not tolerated.
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exposure 400 mg/day or 600mg/day,
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Arm B
Sunitinib 37.5 mg/day, continuous taking, or 50 mg/day (4/2), began within 6 weeks after surgery, and was continuously administered until tumor progression, recurrence or adverse reactions were not tolerated
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exposure 37.5 mg/day, continuous taking, or 50 mg/day (4/2)
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Efficiency
大体时间：12 months
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The curative effect was evaluated by measuring the unprogression-survival (PFS) each treatment group.
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12 months
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Security
大体时间：12 months
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Clinical and laboratory toxicity/symptoms will be graded according to the nci-ctc toxicity criteria.
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12 months
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Molecular marker detection
大体时间：12 months
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Gene mutation of c-kit/PDGFRA of imatinib resistance
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12 months
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Abrams TJ, Lee LB, Murray LJ, Pryer NK, Cherrington JM. SU11248 inhibits KIT and platelet-derived growth factor receptor beta in preclinical models of human small cell lung cancer. Mol Cancer Ther. 2003 May;2(5):471-8.
- Rubin BP, Singer S, Tsao C, Duensing A, Lux ML, Ruiz R, Hibbard MK, Chen CJ, Xiao S, Tuveson DA, Demetri GD, Fletcher CD, Fletcher JA. KIT activation is a ubiquitous feature of gastrointestinal stromal tumors. Cancer Res. 2001 Nov 15;61(22):8118-21.
- Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002 May;33(5):459-65. doi: 10.1053/hupa.2002.123545.
- Demetri GD, van Oosterom AT, Garrett CR, Blackstein ME, Shah MH, Verweij J, McArthur G, Judson IR, Heinrich MC, Morgan JA, Desai J, Fletcher CD, George S, Bello CL, Huang X, Baum CM, Casali PG. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006 Oct 14;368(9544):1329-38. doi: 10.1016/S0140-6736(06)69446-4.
- Graadt van Roggen JF, van Velthuysen ML, Hogendoorn PC. The histopathological differential diagnosis of gastrointestinal stromal tumours. J Clin Pathol. 2001 Feb;54(2):96-102. doi: 10.1136/jcp.54.2.96.
- DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000 Jan;231(1):51-8. doi: 10.1097/00000658-200001000-00008.
- 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 May;8(5):617-24. doi: 10.2217/fon.12.29.
- Blackstein ME, Blay JY, Corless C, Driman DK, Riddell R, Soulieres D, Swallow CJ, Verma S; Canadian Advisory Committee on GIST. Gastrointestinal stromal tumours: consensus statement on diagnosis and treatment. Can J Gastroenterol. 2006 Mar;20(3):157-63. doi: 10.1155/2006/434761.
- Goettsch WG, Bos SD, Breekveldt-Postma N, Casparie M, Herings RM, Hogendoorn PC. Incidence of gastrointestinal stromal tumours is underestimated: results of a nation-wide study. Eur J Cancer. 2005 Dec;41(18):2868-72. doi: 10.1016/j.ejca.2005.09.009. Epub 2005 Nov 15.
- Mendel DB, Laird AD, Xin X, Louie SG, Christensen JG, Li G, Schreck RE, Abrams TJ, Ngai TJ, Lee LB, Murray LJ, Carver J, Chan E, Moss KG, Haznedar JO, Sukbuntherng J, Blake RA, Sun L, Tang C, Miller T, Shirazian S, McMahon G, Cherrington JM. In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: determination of a pharmacokinetic/pharmacodynamic relationship. Clin Cancer Res. 2003 Jan;9(1):327-37.
- O'Farrell AM, Abrams TJ, Yuen HA, Ngai TJ, Louie SG, Yee KW, Wong LM, Hong W, Lee LB, Town A, Smolich BD, Manning WC, Murray LJ, Heinrich MC, Cherrington JM. SU11248 is a novel FLT3 tyrosine kinase inhibitor with potent activity in vitro and in vivo. Blood. 2003 May 1;101(9):3597-605. doi: 10.1182/blood-2002-07-2307. Epub 2003 Jan 16.
- Schlessinger J. Cell signaling by receptor tyrosine kinases. Cell. 2000 Oct 13;103(2):211-25. doi: 10.1016/s0092-8674(00)00114-8. No abstract available.
- Bello C. B. Houk, L. Sherman, et al. Effect of rifampin on the pharmacokinetics of SU11248 in healthy volunteers. Proc.ASCO abstr#3078, 2005.
- Blanke CD, Rankin C, Demetri GD, Ryan CW, von Mehren M, Benjamin RS, Raymond AK, Bramwell VH, Baker LH, Maki RG, Tanaka M, Hecht JR, Heinrich MC, Fletcher CD, Crowley JJ, Borden EC. Phase III randomized, intergroup trial assessing imatinib mesylate at two dose levels in patients with unresectable or metastatic gastrointestinal stromal tumors expressing the kit receptor tyrosine kinase: S0033. J Clin Oncol. 2008 Feb 1;26(4):626-32. doi: 10.1200/JCO.2007.13.4452.
- Zalcberg JR, Verweij J, Casali PG, Le Cesne A, Reichardt P, Blay JY, Schlemmer M, Van Glabbeke M, Brown M, Judson IR; EORTC Soft Tissue and Bone Sarcoma Group, the Italian Sarcoma Group; Australasian Gastrointestinal Trials Group. Outcome of patients with advanced gastro-intestinal stromal tumours crossing over to a daily imatinib dose of 800 mg after progression on 400 mg. Eur J Cancer. 2005 Aug;41(12):1751-7. doi: 10.1016/j.ejca.2005.04.034.
- Demetri GD, Garrett CR, Schoffski P, Shah MH, Verweij J, Leyvraz S, Hurwitz HI, Pousa AL, Le Cesne A, Goldstein D, Paz-Ares L, Blay JY, McArthur GA, Xu QC, Huang X, Harmon CS, Tassell V, Cohen DP, Casali PG. Complete longitudinal analyses of the randomized, placebo-controlled, phase III trial of sunitinib in patients with gastrointestinal stromal tumor following imatinib failure. Clin Cancer Res. 2012 Jun 1;18(11):3170-9. doi: 10.1158/1078-0432.CCR-11-3005.
- Vincenzi B, Nannini M, Fumagalli E, Bronte G, Frezza AM, De Lisi D, Spalato Ceruso M, Santini D, Badalamenti G, Pantaleo MA, Russo A, Dei Tos AP, Casali P, Tonini G. Imatinib dose escalation versus sunitinib as a second line treatment in KIT exon 11 mutated GIST: a retrospective analysis. Oncotarget. 2016 Oct 25;7(43):69412-69419. doi: 10.18632/oncotarget.5136.
- Hsu CC, Wu CE, Chen JS, Tseng JH, Chiang KC, Liu YY, Tsai CY, Cheng CT, Chen TW, Jan YY, Yeh TS, Chen YY, Yeh CN. Imatinib escalation or sunitinib treatment after first-line imatinib in metastatic gastrointestinal stromal tumor patients. Anticancer Res. 2014 Sep;34(9):5029-36.
- Fairweather M, Balachandran VP, Li GZ, Bertagnolli MM, Antonescu C, Tap W, Singer S, DeMatteo RP, Raut CP. Cytoreductive Surgery for Metastatic Gastrointestinal Stromal Tumors Treated With Tyrosine Kinase Inhibitors: A 2-institutional Analysis. Ann Surg. 2018 Aug;268(2):296-302. doi: 10.1097/SLA.0000000000002281.
- Raut CP, Posner M, Desai J, Morgan JA, George S, Zahrieh D, Fletcher CD, Demetri GD, Bertagnolli MM. Surgical management of advanced gastrointestinal stromal tumors after treatment with targeted systemic therapy using kinase inhibitors. J Clin Oncol. 2006 May 20;24(15):2325-31. doi: 10.1200/JCO.2005.05.3439.
- DeMatteo RP, Maki RG, Singer S, Gonen M, Brennan MF, Antonescu CR. Results of tyrosine kinase inhibitor therapy followed by surgical resection for metastatic gastrointestinal stromal tumor. Ann Surg. 2007 Mar;245(3):347-52. doi: 10.1097/01.sla.0000236630.93587.59.
- Gronchi A, Fiore M, Miselli F, Lagonigro MS, Coco P, Messina A, Pilotti S, Casali PG. Surgery of residual disease following molecular-targeted therapy with imatinib mesylate in advanced/metastatic GIST. Ann Surg. 2007 Mar;245(3):341-6. doi: 10.1097/01.sla.0000242710.36384.1b.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2017年6月2日
初级完成 (预期的)
2018年6月2日
研究完成 (预期的)
2018年8月8日
研究注册日期
首次提交
2018年1月3日
首先提交符合 QC 标准的
2018年1月31日
首次发布 (实际的)
2018年2月7日
研究记录更新
最后更新发布 (实际的)
2018年3月1日
上次提交的符合 QC 标准的更新
2018年2月28日
最后验证
2018年2月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
要旨的临床试验
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Arog Pharmaceuticals, Inc.Centre Leon Berard; Fox Chase Cancer Center未知
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Centre Leon Berard招聘中
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Second Affiliated Hospital, School of Medicine,...尚未招聘
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Centre Leon Berard招聘中转移性胃肠道间质瘤 | 不可切除的胃肠道间质瘤 (GIST) | 局部晚期胃肠道间质瘤 (GIST)法国
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Centre Oscar LambretCentre de traitement des données du Cancéropôle Nord-Ouest, Centre F. BACLESSE, Caen, France; Canther, Lille尚未招聘
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Novartis Pharmaceuticals完全的GIST 和 CML美国, 中国, 芬兰, 新加坡, 法国, 瑞士, 泰国, 罗马尼亚, 英国, 香港, 土耳其（türkiye）
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First Affiliated Hospital, Sun Yat-Sen University完全的
Imatinib 400mg的临床试验
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National Institute of Allergy and Infectious Diseases...National Institutes of Health (NIH); Department of Health and Human Services; Dale and Betty Bumpers...招聘中
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Oswaldo Cruz FoundationConselho Nacional de Desenvolvimento Científico e Tecnológico招聘中
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National Institute of Allergy and Infectious Diseases...撤销
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Clarent Biopharma, Inc.Innovacion y Desarrollo de Estrategias en Salud; Elemental Traslational Research SAPI; Elemental...尚未招聘
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CStone PharmaceuticalsBlueprint Medicines Corporation完全的
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Fundacion para la Investigacion Biomedica del Hospital...尚未招聘