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

Lee, Chee Khoon; Goldstein, David; Gibbs, Emma; Joensuu, Heikki; Zalcberg, John; Verweij, Jaap; Casali, Paolo G; Maki, Robert G; Cioffi, Angela; McArthur, Grant; Lord, Sarah J; Yip, Desmond; Kanjanapan, Yada; Rutkowski, Piotr

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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...[Show more]

dc.contributor.authorLee, Chee Khoon
dc.contributor.authorGoldstein, David
dc.contributor.authorGibbs, Emma
dc.contributor.authorJoensuu, Heikki
dc.contributor.authorZalcberg, John
dc.contributor.authorVerweij, Jaap
dc.contributor.authorCasali, Paolo G
dc.contributor.authorMaki, Robert G
dc.contributor.authorCioffi, Angela
dc.contributor.authorMcArthur, Grant
dc.contributor.authorLord, Sarah J
dc.contributor.authorYip, Desmond
dc.contributor.authorKanjanapan, Yada
dc.contributor.authorRutkowski, Piotr
dc.date.accessioned2015-07-03T04:59:39Z
dc.date.available2015-07-03T04:59:39Z
dc.identifier.issn0959-8049
dc.identifier.urihttp://hdl.handle.net/1885/14195
dc.description.abstractPURPOSE 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.
dc.publisherElsevier
dc.rights© 2015 Elsevier Ltd.
dc.sourceEuropean Journal of Cancer
dc.subjectgastrointestinal stromal tumour
dc.subjectimatinib
dc.subjectnomogram
dc.subjectprognosis
dc.titleDevelopment and validation of prognostic nomograms for metastatic gastrointestinal stromal tumour treated with imatinib
dc.typeJournal article
local.identifier.citationvolume51
dcterms.dateAccepted2015-02-26
dc.date.issued2015-03-19
local.publisher.urlhttp://www.elsevier.com/
local.type.statusPublished Version
local.contributor.affiliationYip, D., Medical School, The Australian National University
local.identifier.essn1879-0852
local.bibliographicCitation.issue7
local.bibliographicCitation.startpage852
local.bibliographicCitation.lastpage860
local.identifier.doi10.1016/j.ejca.2015.02.015
CollectionsANU Research Publications

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