Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors

Katsuhiro Kobayashi, Janio Szklaruk, Jonathan Trent, Joe Ensor, Kamran Ahrar, Michael J. Wallace, David C. Madoff, Ravi Murthy, Marshall E. Hicks, Sanjay Gupta

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: We evaluated the efficacy of embolotherapy including hepatic arterial embolization and chemoembolization in patients with imatinib-resistant gastrointestinal stromal tumors with progressive liver metastases. Methods: Medical records and computed tomography images of patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases who underwent embolotherapy from January 2002 through January 2007 were retrospectively reviewed. Response was assessed by Response Evaluation Criteria in Solid Tumors and modified CT response criteria that assessed tumor density changes. Progression-free survival in the liver and overall survival rates were calculated from the date of the initial embolotherapy session using the Kaplan-Meier method. Correlations between disease status or treatment variables and survival were tested in univariate and multivariate analyses using the log-rank test, and the Cox proportional hazards model, respectively. Results: Fourteen patients with gastrointestinal stromal tumor who had been treated with imatinib for 7 to 61 months underwent 26 sessions of embolotherapy. Radiologic response could be evaluated in 13 patients. On the basis of response evaluation criteria in solid tumors, 1 patient demonstrated a partial response and the remaining 12 patients demonstrated stable disease. On the basis of the modified CT response criteria, 7 patients demonstrated a partial response and 6 patients demonstrated stable disease. Progression-free survival rates in the liver were 78.7%, 31.4%, and 31.4% at 6 months, 1, and 3 years, respectively; the median progression-free survival time was 7.0 months. Overall survival rates were 78.6%, 45.8%, and 45.8% at 6 month, 1 year, and 3 year, respectively; the median overall survival time was 9.7 months. Patients who had progressive extrahepatic metastases at the time of treatment and those who received only 1 embolotherapy treatment had shorter OS than did patients with liver-only progression and those who received 2 or more treatment sessions, respectively. Conclusions: Hepatic arterial embolization and chemoembolization induced radiologic response or disease stabilization in most patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases. Patients with progressive extrahepatic metastases or those who are not amenable to more than 1 embolotherapy sessions, however, did not demonstrate an appreciable survival benefit following embolotherapy.

Original languageEnglish
Pages (from-to)574-581
Number of pages8
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume32
Issue number6
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Fingerprint

Gastrointestinal Stromal Tumors
Therapeutic Embolization
Liver
Neoplasm Metastasis
Disease-Free Survival
Survival Rate
Survival
Imatinib Mesylate
Therapeutics
Proportional Hazards Models
Medical Records
Multivariate Analysis
Tomography

Keywords

  • Gastrointestinal stromal tumor
  • Hepatic arterial embolization/chemoembolization
  • Imatinib resistance

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors. / Kobayashi, Katsuhiro; Szklaruk, Janio; Trent, Jonathan; Ensor, Joe; Ahrar, Kamran; Wallace, Michael J.; Madoff, David C.; Murthy, Ravi; Hicks, Marshall E.; Gupta, Sanjay.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 32, No. 6, 01.12.2009, p. 574-581.

Research output: Contribution to journalArticle

Kobayashi, K, Szklaruk, J, Trent, J, Ensor, J, Ahrar, K, Wallace, MJ, Madoff, DC, Murthy, R, Hicks, ME & Gupta, S 2009, 'Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 32, no. 6, pp. 574-581. https://doi.org/10.1097/COC.0b013e31819cca35
Kobayashi, Katsuhiro ; Szklaruk, Janio ; Trent, Jonathan ; Ensor, Joe ; Ahrar, Kamran ; Wallace, Michael J. ; Madoff, David C. ; Murthy, Ravi ; Hicks, Marshall E. ; Gupta, Sanjay. / Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2009 ; Vol. 32, No. 6. pp. 574-581.
@article{43789468c94b47f08e2b24ab3b772047,
title = "Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors",
abstract = "Objectives: We evaluated the efficacy of embolotherapy including hepatic arterial embolization and chemoembolization in patients with imatinib-resistant gastrointestinal stromal tumors with progressive liver metastases. Methods: Medical records and computed tomography images of patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases who underwent embolotherapy from January 2002 through January 2007 were retrospectively reviewed. Response was assessed by Response Evaluation Criteria in Solid Tumors and modified CT response criteria that assessed tumor density changes. Progression-free survival in the liver and overall survival rates were calculated from the date of the initial embolotherapy session using the Kaplan-Meier method. Correlations between disease status or treatment variables and survival were tested in univariate and multivariate analyses using the log-rank test, and the Cox proportional hazards model, respectively. Results: Fourteen patients with gastrointestinal stromal tumor who had been treated with imatinib for 7 to 61 months underwent 26 sessions of embolotherapy. Radiologic response could be evaluated in 13 patients. On the basis of response evaluation criteria in solid tumors, 1 patient demonstrated a partial response and the remaining 12 patients demonstrated stable disease. On the basis of the modified CT response criteria, 7 patients demonstrated a partial response and 6 patients demonstrated stable disease. Progression-free survival rates in the liver were 78.7{\%}, 31.4{\%}, and 31.4{\%} at 6 months, 1, and 3 years, respectively; the median progression-free survival time was 7.0 months. Overall survival rates were 78.6{\%}, 45.8{\%}, and 45.8{\%} at 6 month, 1 year, and 3 year, respectively; the median overall survival time was 9.7 months. Patients who had progressive extrahepatic metastases at the time of treatment and those who received only 1 embolotherapy treatment had shorter OS than did patients with liver-only progression and those who received 2 or more treatment sessions, respectively. Conclusions: Hepatic arterial embolization and chemoembolization induced radiologic response or disease stabilization in most patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases. Patients with progressive extrahepatic metastases or those who are not amenable to more than 1 embolotherapy sessions, however, did not demonstrate an appreciable survival benefit following embolotherapy.",
keywords = "Gastrointestinal stromal tumor, Hepatic arterial embolization/chemoembolization, Imatinib resistance",
author = "Katsuhiro Kobayashi and Janio Szklaruk and Jonathan Trent and Joe Ensor and Kamran Ahrar and Wallace, {Michael J.} and Madoff, {David C.} and Ravi Murthy and Hicks, {Marshall E.} and Sanjay Gupta",
year = "2009",
month = "12",
day = "1",
doi = "10.1097/COC.0b013e31819cca35",
language = "English",
volume = "32",
pages = "574--581",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Hepatic arterial embolization and chemoembolization for imatinib-resistant gastrointestinal stromal tumors

AU - Kobayashi, Katsuhiro

AU - Szklaruk, Janio

AU - Trent, Jonathan

AU - Ensor, Joe

AU - Ahrar, Kamran

AU - Wallace, Michael J.

AU - Madoff, David C.

AU - Murthy, Ravi

AU - Hicks, Marshall E.

AU - Gupta, Sanjay

PY - 2009/12/1

Y1 - 2009/12/1

N2 - Objectives: We evaluated the efficacy of embolotherapy including hepatic arterial embolization and chemoembolization in patients with imatinib-resistant gastrointestinal stromal tumors with progressive liver metastases. Methods: Medical records and computed tomography images of patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases who underwent embolotherapy from January 2002 through January 2007 were retrospectively reviewed. Response was assessed by Response Evaluation Criteria in Solid Tumors and modified CT response criteria that assessed tumor density changes. Progression-free survival in the liver and overall survival rates were calculated from the date of the initial embolotherapy session using the Kaplan-Meier method. Correlations between disease status or treatment variables and survival were tested in univariate and multivariate analyses using the log-rank test, and the Cox proportional hazards model, respectively. Results: Fourteen patients with gastrointestinal stromal tumor who had been treated with imatinib for 7 to 61 months underwent 26 sessions of embolotherapy. Radiologic response could be evaluated in 13 patients. On the basis of response evaluation criteria in solid tumors, 1 patient demonstrated a partial response and the remaining 12 patients demonstrated stable disease. On the basis of the modified CT response criteria, 7 patients demonstrated a partial response and 6 patients demonstrated stable disease. Progression-free survival rates in the liver were 78.7%, 31.4%, and 31.4% at 6 months, 1, and 3 years, respectively; the median progression-free survival time was 7.0 months. Overall survival rates were 78.6%, 45.8%, and 45.8% at 6 month, 1 year, and 3 year, respectively; the median overall survival time was 9.7 months. Patients who had progressive extrahepatic metastases at the time of treatment and those who received only 1 embolotherapy treatment had shorter OS than did patients with liver-only progression and those who received 2 or more treatment sessions, respectively. Conclusions: Hepatic arterial embolization and chemoembolization induced radiologic response or disease stabilization in most patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases. Patients with progressive extrahepatic metastases or those who are not amenable to more than 1 embolotherapy sessions, however, did not demonstrate an appreciable survival benefit following embolotherapy.

AB - Objectives: We evaluated the efficacy of embolotherapy including hepatic arterial embolization and chemoembolization in patients with imatinib-resistant gastrointestinal stromal tumors with progressive liver metastases. Methods: Medical records and computed tomography images of patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases who underwent embolotherapy from January 2002 through January 2007 were retrospectively reviewed. Response was assessed by Response Evaluation Criteria in Solid Tumors and modified CT response criteria that assessed tumor density changes. Progression-free survival in the liver and overall survival rates were calculated from the date of the initial embolotherapy session using the Kaplan-Meier method. Correlations between disease status or treatment variables and survival were tested in univariate and multivariate analyses using the log-rank test, and the Cox proportional hazards model, respectively. Results: Fourteen patients with gastrointestinal stromal tumor who had been treated with imatinib for 7 to 61 months underwent 26 sessions of embolotherapy. Radiologic response could be evaluated in 13 patients. On the basis of response evaluation criteria in solid tumors, 1 patient demonstrated a partial response and the remaining 12 patients demonstrated stable disease. On the basis of the modified CT response criteria, 7 patients demonstrated a partial response and 6 patients demonstrated stable disease. Progression-free survival rates in the liver were 78.7%, 31.4%, and 31.4% at 6 months, 1, and 3 years, respectively; the median progression-free survival time was 7.0 months. Overall survival rates were 78.6%, 45.8%, and 45.8% at 6 month, 1 year, and 3 year, respectively; the median overall survival time was 9.7 months. Patients who had progressive extrahepatic metastases at the time of treatment and those who received only 1 embolotherapy treatment had shorter OS than did patients with liver-only progression and those who received 2 or more treatment sessions, respectively. Conclusions: Hepatic arterial embolization and chemoembolization induced radiologic response or disease stabilization in most patients with imatinib-resistant gastrointestinal stromal tumor with progressive liver metastases. Patients with progressive extrahepatic metastases or those who are not amenable to more than 1 embolotherapy sessions, however, did not demonstrate an appreciable survival benefit following embolotherapy.

KW - Gastrointestinal stromal tumor

KW - Hepatic arterial embolization/chemoembolization

KW - Imatinib resistance

UR - http://www.scopus.com/inward/record.url?scp=73349109803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73349109803&partnerID=8YFLogxK

U2 - 10.1097/COC.0b013e31819cca35

DO - 10.1097/COC.0b013e31819cca35

M3 - Article

C2 - 19636238

AN - SCOPUS:73349109803

VL - 32

SP - 574

EP - 581

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 6

ER -