KIT and PDGFRA mutations and the risk of GI stromal tumor recurrence.
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Authors
Joensuu, HeikkiRutkowski, Piotr
Nishida, Toshirou
Steigen, Sonja E
Brabec, Peter
Plank, Lukas
Nilsson, Bengt
Braconi, Chiara
Bordoni, Andrea
Magnusson, Magnus K
Sufliarsky, Jozef
Federico, Massimo
Jonasson, Jon G
Hostein, Isabelle
Bringuier, Pierre-Paul
Emile, Jean-Francois
Issue Date
2015-02-20
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J. Clin. Oncol. 2015, 33 (6):634-42Abstract
Mutated KIT and platelet-derived growth factor alpha gene (PDGFRA) drive GI stromal tumor (GIST) oncogenesis, but the clinical significance of their single mutations is known incompletely.We identified 11 population-based series of patients with GIST through a literature search and pooled individual data from 3,067 patients treated with macroscopically complete tumor excision. Mutation analysis was done from 1,505 tumors. We analyzed associations between KIT and PDGFRA mutations and recurrence-free survival (RFS) in the subsets in which patients were treated with surgery alone.
We identified 301 different single mutations in KIT and 33 in PDGFRA. Patients with PDGFRA mutations had more favorable RFS than those with KIT mutations (hazard ratio, 0.34; P = .004). Only one of the 35 GISTs with KIT exon 11 duplication mutations recurred. Patients with deletions of only one codon of KIT exon 11 had better RFS than those with another deletion type, and some KIT exon 11 substitution mutations (Trp557Arg, Val559Ala, and Leu576Pro) were also associated with favorable RFS. Patients with an identical mutation had greatly variable outcomes depending on the standard prognostic factors, notably, mitotic count. Commonly used risk stratification schemes tended to overestimate the risk for recurrence in subgroups with prognostically favorable mutations.
GISTs with an identical KIT or PDGFRA mutation may have widely varying risks for recurrence. Most of the patients with PDGFRA mutations and those with KIT exon 11 duplication mutation or deletion of one codon have favorable RFS with surgery alone and are usually not candidates for adjuvant therapy.
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http://jco.ascopubs.org/content/33/6/634.longhttp://jco.ascopubs.org/content/33/6/634.full.pdf
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Archived with thanks to Journal of clinical oncology : official journal of the American Society of Clinical Oncologyae974a485f413a2113503eed53cd6c53
10.1200/JCO.2014.57.4970
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