Gastrointestinal Cancers Symposium
SAN FRANCISCO — Sorafenib appears to be a viable treatment option for
patients with gastrointestinal stromal tumors who are resistant to imatinib and
Results from a phase 2 trial of 38 patients with
gastrointestinal stromal tumors (GIST) assigned to the
targeted tyrosine kinase inhibitor sorafenib (Nexavar, Bayer) showed that
tumors decreased in 13% of patients and were stable in 55% of patients.
“These data demonstrate that sorafenib has definite
activity in imatinib- and sunitinib-resistant GIST,” said Nicholas P.
Campbell, MD, an oncology fellow at the University of Chicago.
“Prolonged disease control is possible in these refractory patients, even
in those with primary sunitinib resistance.”
Campbell presented the results during a press conference
in advance of the 2011 Gastrointestinal Cancers Symposium.
Six patients in the study were resistant to imatinib
(Gleevec, Novartis) and 32 were resistant to both imatinib and sunitinib
(Sutent, CPPI CV). Patients — all of whom were diagnosed with
unresectable, KIT-expressing GIST — were assigned to 400 mg
sorafenib for 28 days. Patients underwent a median of four
cycles of therapy (one-40 cycles), and 61% had at least one dose reduction.
After a median follow-up of 31 months, disease control
rate was 68%, median PFS was 5.2 months and median OS was 11.6 months.
Patients in the group that was resistant to imatinib
alone were more likely to undergo dose reduction (83% vs. 59%), but the small
size of that group likely played a role in the difference.
Campbell said the most common grade-3 adverse events
were hand-foot syndrome (45%) and hypertension (21%).
“After failure on imatinib and sunitinib, there are
limited therapeutic options,” Campbell said. “There is an urgent need
for additional agents to treat patients with imatinib- and sunitinib-refractory
GIST, since there are no FDA–approved options for these patients other
than resumption of imatinib.” – by Jason Harris
For more information:
- Campbell NP. #4. Presented at: the 2011 Gastrointestinal
Cancers Symposium; Jan. 20-22, 2011; San Francisco.
Disclosure: Dr. Campbell has no relevant financial
Our patients with metastatic GIST do very well — they live on
average at least 4 years after diagnosis. Unfortunately, many patients have
limited options at some point during their illness. By understanding the
molecular mechanisms behind GIST, we have been able to make great strides in
our care of these patients. Over the past 10 years, two medications have been
approved for treatment of advanced GIST. This presentation demonstrates that
additional treatments may be on the horizon because of our investment into
– Jennifer C. Obel, MD,
Clinical Professor of Medicine, University of Chicago
Disclosure: Dr. Obel has no relevant financial disclosures.