PMID- 33131035
OWN - NLM
STAT- MEDLINE
DCOM- 20210414
LR  - 20210414
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Linking)
VI  - 38
IP  - 1
DP  - 2021 Jan
TI  - Comparative Efficacy and Safety of Different Regimens of Advanced 
      Gastrointestinal Stromal Tumors After Failure Prior Tyrosine Kinase Inhibitors: A 
      Network Meta-Analysis.
PG  - 399-412
LID - 10.1007/s12325-020-01545-1 [doi]
AB  - INTRODUCTION: The prospect of targeted therapies for advanced gastrointestinal 
      stromal tumors (GISTs) has been dramatically transformed after encouraging 
      results achieved in recent clinical trials. At present, the number of second- and 
      third-line treatments are increasing, although the challenge is to take into 
      account the differences between these interventions. Therefore, our goal is to 
      evaluate the investigation of different regimens currently used in GISTs based on 
      findings from phase II or phase III randomized controlled trials (RCTs), and then 
      indirectly compare the effectiveness and safety of the available therapies. 
      METHODS: The qualified literatures in relevant sources were searched 
      systematically. Studies to identify RCTs of which main endpoints were 
      progression-free survival (PFS), overall survival (OS), and grade 3 or more 
      adverse events (AEs) in patients with GISTs were considered for inclusion. 
      RESULTS: Eight RCTs met our inclusion criteria, which involved 2351 patients. For 
      PFS, compared with placebo, imatinib, and sunitinib, regorafenib (HR = 0.12, 95% 
      CI 0.07-0.23; HR = 0.27, 95% CI 0.19-0.39; HR = 0.36, 95% CI 0.19-0.72, 
      respectively) and ripretinib (HR = 0.15, 95% CI 0.09-0.25; HR = 0.33, 95% CI 
      0.16-0.68; HR = 0.44, 95% CI 0.25-0.78, respectively) were significantly 
      correlated with the improvement of PFS, and regorafenib may be the preferred 
      option according to the analysis of treatment rankings. For OS, compared with 
      placebo, imatinib, and sunitinib, masitinib (HR = 0.13, 95% CI 0.04-0.44; 
      HR = 0.13, 95% CI 0.04-0.51; HR = 0.27, 95%CI 0.09-0.84) and ripretinib 
      (HR = 0.36, 95% CI 0.21-0.62; HR = 0.36, 95% CI 0.16-0.80; HR = 0.18, 95% CI 
      0.09-0.36, respectively) were significantly more effective, and masitinib may be 
      the best choice according to treatment ranking analysis. Statistically, 
      regorafenib can be considered to be the highest in high-grade AEs, while the rate 
      of severe AEs of ripretinib and masitinib was likely the lowest. CONCLUSION: Our 
      results show that ripretinib has the most favorable balance between effectiveness 
      and tolerability among the different treatment regimens for GISTs.
FAU - Zhang, Xue
AU  - Zhang X
AUID- ORCID: 0000-0002-3486-366X
AD  - Department of Pharmacy, Kunming Yan'an Hospital, Yan'an Affiliated Hospital of 
      Kunming Medical University, Kunming, 650051, China.
FAU - Liang, Yueqin
AU  - Liang Y
AD  - Department of Pharmacy, Kunming Yan'an Hospital, Yan'an Affiliated Hospital of 
      Kunming Medical University, Kunming, 650051, China.
FAU - Li, Yanhua
AU  - Li Y
AD  - Department of Pharmacy, Kunming Yan'an Hospital, Yan'an Affiliated Hospital of 
      Kunming Medical University, Kunming, 650051, China.
FAU - Yin, Jiafu
AU  - Yin J
AD  - Department of Pharmacy, Tumor Hospital of Yunnan Province, Third Affiliated 
      Hospital To Kunming Medical University, Kunming, 650118, China. 
      yinjiafuzlyy@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20201101
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Naphthyridines)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 8W8T17847W (Urea)
RN  - 9XW757O13D (ripretinib)
MH  - *Antineoplastic Agents/adverse effects
MH  - *Gastrointestinal Stromal Tumors/drug therapy
MH  - Humans
MH  - Naphthyridines
MH  - Network Meta-Analysis
MH  - Protein Kinase Inhibitors/adverse effects
MH  - Urea/analogs & derivatives
OTO - NOTNLM
OT  - Different regimens
OT  - Efficacy and safety
OT  - Gastrointestinal stromal tumors
OT  - Network meta-analysis
EDAT- 2020/11/02 06:00
MHDA- 2021/04/15 06:00
CRDT- 2020/11/01 20:43
PHST- 2020/09/16 00:00 [received]
PHST- 2020/10/20 00:00 [accepted]
PHST- 2020/11/02 06:00 [pubmed]
PHST- 2021/04/15 06:00 [medline]
PHST- 2020/11/01 20:43 [entrez]
AID - 10.1007/s12325-020-01545-1 [pii]
AID - 10.1007/s12325-020-01545-1 [doi]
PST - ppublish
SO  - Adv Ther. 2021 Jan;38(1):399-412. doi: 10.1007/s12325-020-01545-1. Epub 2020 Nov 
      1.