Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate.

Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate. Research Abstract Details 

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Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate. Abstract Text:

John C McAuliffe,Alexander J F Lazar,Dan Yang,Dejka M Steinert,Wei Qiao,Peter F Thall,A Kevin Raymond,Robert S Benjamin,Jonathan C Trent,John C McAuliffe,Alexander J F Lazar,Dan Yang,Dejka M Steinert,Wei Qiao,Peter F Thall,A Kevin Raymond,Robert S Benjamin,Jonathan C Trent,John C McAuliffe,Alexander J F Lazar,Dan Yang,Dejka M Steinert,Wei Qiao,Peter F Thall,A Kevin Raymond,Robert S Benjamin,Jonathan C Trent,John C McAuliffe,Alexander J F Lazar,Dan Yang,Dejka M Steinert,Wei Qiao,Peter F Thall,A Kevin Raymond,Robert S Benjamin,Jonathan C Trent,

PURPOSE: Imatinib mesylate (imatinib) has revolutionized clinical outcomes of patients with advanced gastrointestinal stromal tumor (GIST). However, the degree of individual benefit varies, and little is known about prognostic factors for these patients. Importantly, selected patients may be treated with an approach to target both Kit and vascular endothelial growth factor receptor (VEGFR) expression. EXPERIMENTAL DESIGN: Using tissue microarray technology, we analyzed 53 imatinib-naive GISTs for vascular endothelial growth factor (VEGF) expression from patients who then received imatinib. In multivariate analyses, we evaluated overall survival (OS) and progression-free survival (PFS) of these patients based on putative prognostic factors, including VEGF expression. In a separate study, 12 matched pre-imatinib and post-imatinib GIST patient specimens and two human GIST cell lines were assessed for VEGF production in response to imatinib. RESULTS: Independent of kit genotype, patients with GIST expressing high VEGF had inferior median PFS (7.1 months versus 29 months, P = 0.42) and median OS (20 months versus not reached at >50 months; P = 0.02) compared with weak or nonexpressers of VEGF. Non-exon 11 kit mutation predicted inferior PFS but not OS. High mitotic rate was marginally predictive of improved OS. Imatinib resulted in decreased production of VEGF in only a subset of GIST patients (2 of 12) and both cell lines. CONCLUSIONS: We present a study to address the prognostic factors for patients with GIST in the imatinib era. We present a rationale to consider exploration of a front-line therapy of GIST with a regimen targeting both Kit and VEGFR based on the presence of tumor VEGF levels.

Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate. Publishing Authors By Initials

JC McAuliffe,AJ Lazar,D Yang,DM Steinert,W Qiao,PF Thall,AK Raymond,RS Benjamin,JC Trent,JC McAuliffe,AJ Lazar,D Yang,DM Steinert,W Qiao,PF Thall,AK Raymond,RS Benjamin,JC Trent,JC McAuliffe,AJ Lazar,D Yang,DM Steinert,W Qiao,PF Thall,AK Raymond,RS Benjamin,JC Trent,JC McAuliffe,AJ Lazar,D Yang,DM Steinert,W Qiao,PF Thall,AK Raymond,RS Benjamin,JC Trent,

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Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Clinical cancer research : an official journal of

VOLUME: 13

Page Numbers: 6727-34

Journal Abbreviation: Clin. Cancer Res.

ISSN: 1078-0432

DAY: 15

MONTH: Nov

YEAR: 2007

Association of intratumoral vascular endothelial growth factor expression and clinical outcome for patients with gastrointestinal stromal tumors treated with imatinib mesylate. Information

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LANGUAGE: eng

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AFFILIATION: Authors' Affiliations: Departments of Sarcoma Medical Oncology, Pathology, and Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, Texas.

Country: United States

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MEDLINETA: Clin Cancer Res

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