Table 8. Tumor Characteristics Predictive of Disease Response or Survival
Characteristic |
Prognostic Factor |
Studies Indicating an Association and Quality |
Strength of Association with Tumor Response |
Strength of Association with Survival |
c-kit mutation |
c-kit
mutation present vs. absent |
Debiec-Rychter, et al., 2004 (quality = 6/6)59 |
TTP: patients
with C kit mutations less likely to progress (p = 0.03) |
patients with c-kit mutations with longer
OS (p = 0.015) |
Exon
11 mutation |
Debiec-Rychter, et al., 2004 (quality = 6/6)59
Heinrich, et al., 2003 (quality = 6/6)47 |
EFS: c-kit
exon 11 mutation with median EFS 849d; all other mutations EFS 327d
HR
0.17 (0.10-0.29) p < 0.0001a |
HR 0.04 (0.01-0.12) p < 0.0001a |
Exon
9 mutation |
Heinrich, et al., 2003 (quality = 6/6)47 |
|
HR 0.31(0.11-0.89) p =
0.0289a |
Other genes |
Gene
SPRY4 (found to be downregulated by imatinib in in vitro pre-clinical
studies) |
Frolov, et al., 2003 (quality = 1/6)60 |
SPRY4
was "dramatically" decreased in 4/5 patients with PR, expressed
at high levels in the 2/2 non-responders, and initially decreased
then returned to high levels in the 1/5 PR patient who had an early
relapse |
|
Gene
MAFbx (found to be upregulated by imatinib in in vitro pre-clinical
studies) |
Frolov, et al., 2003 (quality = 1/6)60 |
Variable
responses (2/5 PR patients had included levels of MAFbx; initially
increased and then returned to pre-treatment levels in the patient
with PR but early relapse; not changed at all in the one PD patient) |
|
Pathology |
GIST
vs. other STS |
Verweij, et al., 2003 (quality = 6/6)48 |
GIST
with 73% DFS at 1yr
Median
TTP STS = 58d |
|
Abbreviations: TTP
= time to progression; OS = overall survival; EFS =
event free survival; HR = hazard ratio; STS = soft tissue sarcomas; DFS
= disease-free survival.
Note:
a. In this
study hazard rations greater than one are predictive of poorer prognosis.
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