Background

The introduction of molecularly targeted drugs, including imatinib, has greatly improved the prognosis of gastrointestinal stromal tumor (GIST), and based on the different response image, the methods of response evaluation have been established for GISTs. Furthrmore, the best response evaluation using them has been reported to be associated with progression-free survival (PFS) in imatinib treatment. However, since it is more important to predict the clinical outcomes of imatinib treatment in “early treatment phase”, new predicting factor in earlier stage is desired to work out the whole strategy of each patient. Early morphological change (EMC) was previously reported as a predictive marker for molecularly targeted drugs in metastatic colorectal cancer. The purpose of the present study was to verify the efficacy of EMC in predicting the outcome in patients with GIST receiving imatinib at early evaluation.

Methods

We retrospectively reviewed 66 patients. EMC in computed tomography (CT) image was evaluated, and the patients were categorized into two groups: active MR (morphological response) (+) group and active MR (−) group. We investigated the association between the presence of active MR and clinical outcomes.

Results

Forty-five patients had active MR ( +). The median progression-free survival (PFS) in patients with/without active MR was 49/23 months (P = 0.0039).

Conclusion

The evaluation criteria based on EMC could be a sensitive method to predict the clinical outcome of imatinib treatment for patients with unresectable GIST.

中文翻译：

---

使用伊马替尼治疗胃肠道间质瘤患者早期形态学变化的新反应评估标准

背景

包括伊马替尼在内的分子靶向药物的引入极大地改善了胃肠道间质瘤（GIST）的预后，并基于不同的反应图像，建立了GISTs的反应评估方法。此外，据报道，使用它们的最佳反应评估与伊马替尼治疗中的无进展生存期 (PFS) 相关。然而，由于在“早期治疗阶段”预测伊马替尼治疗的临床结果更为重要，因此需要新的早期预测因素来制定每个患者的整体策略。早期形态学变化 (EMC) 曾被报道为转移性结直肠癌中分子靶向药物的预测标志物。

方法

我们回顾性分析了 66 名患者。评估计算机断层扫描（CT）图像中的EMC，并将患者分为两组：活动性MR（形态学反应）（+）组和活动性MR（-）组。我们调查了活动性 MR 的存在与临床结果之间的关联。

结果

45 名患者有活动性 MR (+)。有/无活动性 MR 患者的中位无进展生存期 (PFS) 为 49/23 个月 ( P  = 0.0039)。

结论

基于EMC的评价标准可能是预测不可切除GIST患者伊马替尼治疗临床结果的一种敏感方法。