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Frequencies of KIT and PDGFRA mutations in the MolecGIST prospective population-based study differ from those of advanced GISTs
Ist Teil von
Medical oncology (Northwood, London, England), 2012-09, Vol.29 (3), p.1765-1772
Ort / Verlag
Boston: Springer US
Erscheinungsjahr
2012
Quelle
MEDLINE
Beschreibungen/Notizen
Gastrointestinal stromal tumors (GISTs) are the most common human sarcoma. Most of the data available on GISTs derive from retrospective studies of patients referred to oncology centers. The MolecGIST study sought to determine and correlate clinicopathological and molecular characteristics of GISTs. Tumor samples and clinical records were prospectively obtained and reviewed for patients diagnosed in France during a 24-month period. Five hundred and ninety-six patients were included, of whom 10% had synchronous metastases. GISTs originated from the stomach, small bowel or other site in 56.4, 30.2 and 13.4% of cases, respectively. The main prognostic markers, tumor localization, size and mitotic index were not independent variables (
P
< 0.0001). Mutational status was determined in 492 (83%) patients, and 138 different mutations were identified.
KIT
and
PDGFRA
mutations were detected in 348 (71%) and 74 (15%) patients, respectively, contrasting with 82.8 and 2.1% in patients with advanced GIST (MetaGIST) (
P
< 0.0001). Further comparison of localized GISTs in the MolecGIST cohort with advanced GISTs from previous clinical trials showed that the mutations of
PDGFRA
exon18 (D842V and others) as well as
KIT
exon11 substitutions (W557R and V559D) were more likely to be seen in patients with localized GISTs (odds ratio 7.9, 3.1, 2.7 and 2.5, respectively), while
KIT
exon 9 502_503dup and
KIT
exon 11 557_559del were more frequent in metastatic GISTs (odds ratio of 0.3 and 0.5, respectively). These data suggest that
KIT
and
PDGFRA
mutations and standardized mitotic count deserve to be investigated to evaluate the relapse risk of GISTs.