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1.
Chinese Journal of Gastrointestinal Surgery ; (12): 216-220, 2013.
Article in Chinese | WPRIM | ID: wpr-314821

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the recurrence-free survival (RFS) and safety of imatinib adjuvant therapy with longer treatment duration in patients undergoing complete resection of localized primary gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>Clinical and follow-up data of 101 GIST patients between March 2004 and May 2009 with intermediate or high recurrence risk receiving imatinib adjuvant treatment and more than 3 years follow-up time in Peking University Cancer Hospital were retrospectively analyzed. Imatinib adjuvant treatment: 3 patients discontinued less than 1 year imatinib treatment because of adverse events; 24, 21 and 18 patients discontinued imatinib after 1 year, 2 years, and 3 years treatment; 8 patients received 3 years adjuvant treatment and were ongoing; 27 patients received more than 4 years imatinib adjuvant treatment.</p><p><b>RESULTS</b>The median follow-up time was 60 months (95%CI:57.9-62.1). Nineteen patients had GIST recurrence, of whom recurrence happened during imatinib adjuvant therapy in 5 patients and after imatinib treatment in 14 patients. The median period from imatinib stopping to recurrence was 12.0 months (95%CI:9.6-14.4). Patients with recurrent GIST achieved tumor control after imatinib resumption. RFS of patients (n=53) with ≥3 years imatinib treatment duration was higher than that of patients (n=48) with <3 years imatinib duration (93.9% vs. 68.0%, P<0.01). In addition, prolonged adjuvant imatinib duration did not significantly increase the adverse events related to treatment (P>0.05).</p><p><b>CONCLUSIONS</b>Prolonged adjuvant imatinib duration may further improve RFS rate further in patients with intermediate or high risk of recurrence after complete tumor resection without increased adverse events.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Benzamides , Therapeutic Uses , Chemotherapy, Adjuvant , Disease-Free Survival , Follow-Up Studies , Gastrointestinal Neoplasms , Drug Therapy , Gastrointestinal Stromal Tumors , Drug Therapy , Imatinib Mesylate , Neoplasm Recurrence, Local , Piperazines , Therapeutic Uses , Pyrimidines , Therapeutic Uses , Retrospective Studies , Treatment Outcome
2.
Chinese Journal of Gastrointestinal Surgery ; (12): 524-528, 2013.
Article in Chinese | WPRIM | ID: wpr-357197

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the correlation of MDR1 and ABCG2 genetic polymorphisms with the efficacy and adverse events of irinotecan chemotherapy in patients with colorectal cancer (CRC).</p><p><b>METHODS</b>Clinical data of CRC patients treated with irinotecan-based chemotherapy in the Peking University Cancer Hospital between January 1996 and December 2011 were collected, and their blood samples were collected accordingly. Genomic DNA was extracted from blood samples. The following SNP detection of MDR1 and ABCG2 genes was conducted by direct sequencing method. The correlation of genetic SNPs with efficacy and toxicity of irinotecan treatment was further analyzed.</p><p><b>RESULTS</b>Allele frequencies of MDR1 2677 G>T/A, ABCG2 421 C>A, 34 G>A, 376 C>T were comparable with previous studies. Genetic SNPs results from peripheral blood samples and tumor tissues were highly consistent. Patients carrying MDR1 2677 wild type had higher clinical benefit than those carrying mutant genotype, while the differences were not significant. The progression-free survival (PFS) was longer in wild-type patients as compared to mutant-type patients in second-line chemotherapy (P=0.012). There were no significant correlations between ABCG2 421 C>A, 34 G>A, 376 C>T and chemotherapy efficacy. No significant correlations were observed between MDR1 2677 G>T/A, ABCG2 421 C>A, ABCG2 34 G>A, ABCG2 376 C>T and irinotecan-related grade 3 and 4 neutropenia or diarrhea.</p><p><b>CONCLUSION</b>MDR1 2677 G>T/A may be served as a biomarker in predicting the efficacy of irinotecan chemotherapy in patients with colorectal cancer.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , ATP Binding Cassette Transporter, Subfamily B , ATP Binding Cassette Transporter, Subfamily G, Member 2 , ATP-Binding Cassette Transporters , Genetics , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Genetics , Camptothecin , Therapeutic Uses , Colorectal Neoplasms , Drug Therapy , Genetics , Neoplasm Proteins , Genetics , Polymorphism, Single Nucleotide , Retrospective Studies , Treatment Outcome
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