Development and validation of prognostic nomograms for metastatic gastrointestinal stromal tumour treated with imatinib

Lee, C. K., Goldstein, D., Gibbs, E., Joensuu, H., Zalcberg, J., Verweij, J., Casali, P. G., Maki, R. G., Cioffi, A., McArthur, G., Lord, S. J., Yip, D., Kanjanapan, Y., Rutkowski, P. (May 2015) Development and validation of prognostic nomograms for metastatic gastrointestinal stromal tumour treated with imatinib. Eur J Cancer, 51 (7). pp. 852-60. ISSN 1879-0852 (Electronic)0959-8049 (Linking)

DOI: 10.1016/j.ejca.2015.02.015


PURPOSE: Metastatic gastrointestinal stromal tumour (GIST) is generally an incurable disease with variable response to imatinib. We aimed to develop prognostic nomograms to predict overall survival (OS) and progression-free survival (PFS) for patients treated with imatinib. METHODS: Nomograms were developed in a training cohort (n=330) of patients treated in a randomised trial (EORTC-ISG-AGITG 62005 phase III study) using Cox regression models, and validated in patients (n=236) treated in routine clinical care from six referral centres. Nomogram performance was assessed by calculating the c statistic. A classification based on the nomograms' scores was generated to group patients according to risk. RESULTS: Nomogram risk factors for OS and PFS were size of the largest metastasis, tumour genotype, primary tumour mitotic count, haemoglobin and blood neutrophil count at commencement of imatinib. The nomograms predicted survival with a c statistic of 0.75 (training) and 0.62 (validation) for OS, and 0.69 (training) and 0.62 (validation) for PFS. When tested in the validation cohort, the nomograms discriminated well the high and intermediate risk from low risk patients (hazard ratio [HR] for OS 3.83, 95% confidence interval [CI] 1.71-8.56; and 2.48, 95% CI 1.12-5.50; for PFS 2.84, 95% CI 1.66-4.87; and 1.45, 95% CI 0.87-2.41, respectively). CONCLUSION: The nomograms predicted the risk of GIST progression and death with good discrimination of risk groups, and may be of value for patient counselling and risk stratification.

Item Type: Paper
Uncontrolled Keywords: Adolescent Adult Aged Aged, 80 and over Antineoplastic Agents/*therapeutic use Benzamides/*therapeutic use Female Gastrointestinal Neoplasms/*diagnosis/*drug therapy/mortality/pathology Gastrointestinal Stromal Tumors/*diagnosis/*drug therapy/mortality/pathology Humans Imatinib Mesylate Male Middle Aged Neoplasm Metastasis *Nomograms Piperazines/*therapeutic use Prognosis Pyrimidines/*therapeutic use Survival Analysis Young Adult Gastrointestinal stromal tumour Imatinib Nomogram
Subjects: diseases & disorders > cancer
diseases & disorders > cancer > drugs and therapies
CSHL Authors:
Communities: CSHL labs > Maki lab
Depositing User: Matt Covey
Date: May 2015
Date Deposited: 20 Oct 2016 14:50
Last Modified: 20 Oct 2016 14:50
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