Results from a phase III trial (GRID) evaluating regorafenib (REG) in metastatic gastrointestinal stromal tumour (GIST): Subgroup analysis of outcomes based on pretreatment characteristics.

Authors

null

Heikki Joensuu

Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland

Heikki Joensuu , Paolo Giovanni Casali , Peter Reichardt , Yoon-Koo Kang , Jean-Yves Blay , Piotr Rutkowski , Hans Gelderblom , Peter Hohenberger , Michael Gordon Leahy , Margaret von Mehren , Giuseppe Badalamenti , Martin E. Blackstein , Axel Le Cesne , Patrick Schoffski , Robert G. Maki , Jian-Ming Xu , Toshirou Nishida , Christian Kappeler , Iris Kuss , George D. Demetri

Organizations

Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, HELIOS Klinikum Berlin-Buch, Berlin, Germany, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Centre Léon Bérard, Lyon, France, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland, Department of Clinical Oncology, Leiden University Medical Center, Leiden, Netherlands, Department of Surgery, Mannheim University Medical Center, Mannheim, Germany, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom, Fox Chase Cancer Center, Philadelphia, PA, Department of Oncology, Medical Oncology Division, University of Palermo, Palermo, Italy, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada, Institut Gustave Roussy, Villejuif, France, Laboratory of Experimental Oncology and Department of General Medical Oncology, KU Leuven and University Hospitals, Leuven, Belgium, Mount Sinai School of Medicine, New York, NY, Cancer Center, 307 Hospital, Academy of Military Medical Science, Beijing, China, Department of Surgery, Osaka Police Hospital, Osaka, Japan, Bayer Pharma AG, Berlin, Germany, Bayer HealthCare Pharmaceuticals, Berlin, Germany, Dana-Farber Cancer Institute/Harvard Medical School, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

Background: REG, an oral receptor kinase inhibitor with activity against KIT, PDGFR, VEGFR, FGFRs, and other oncologic targets, demonstrated significant improvement in progression-free survival (PFS) over placebo (PL) in a phase III study (GRID) of patients (pts) with advanced GIST following failure of at least imatinib (IM) and sunitinib (SU). To understand the impact of pts’ baseline characteristics on outcome, we performed an exploratory analysis of REG effects across pt subgroups based on sex, age, and mitotic index of primary GIST tissue, as well as duration and number of lines of previous therapies. Methods: Adult pts with metastatic GIST (n=199) progressing after at least IM and SU were randomized 2:1 to receive oral REG 160 mg or PL once daily for the first 3 weeks of each 4-week cycle. Subgroup analysis of centrally assessed PFS was performed, based on sex, age (<65, ≥65 years), mitotic index of primary GIST (<5, ≥5 to <10, ≥10 mits/50 hpf), duration of IM and SU treatment (<6, ≥6 to <18, ≥18 months), and number of prior anticancer treatment lines (2 or ≥3). Mitotic index data on primaries were available for 119 patients. Results: REG demonstrated improvement in PFS vs PL in all subgroups, as summarized in the Table. Conclusions: REG had substantial efficacy in all patient subgroups included in this analysis. Clinical trial information: NCT01271712.

Subgroup analysis of PFS from patients in the GRID study.
Subgroup n Hazard ratio for REG vs PL
(95% confidence interval)
Sex Male 127 0.31 (0.20, 0.48)
Female 72 0.18 (0.09, 0.34)
Age <65 136 0.30 (0.19, 0.46)
≥65 63 0.15 (0.08, 0.30)
Duration of prior IM for metastatic GIST <6 22 0.55 (0.17, 1.73)
≥6 to <18 33 0.19 (0.07, 0.55)
≥18 144 0.24 (0.24, 0.36)
Duration of prior SU for metastatic GIST <6 74 0.26 (0.14, 0.47)
≥6 to <18 79 0.30 (0.17, 0.52)

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Sarcoma

Track

Sarcoma

Sub Track

Gastrointestinal Stromal Tumors (GIST)

Clinical Trial Registration Number

NCT01271712

Citation

J Clin Oncol 31, 2013 (suppl; abstr 10551)

DOI

10.1200/jco.2013.31.15_suppl.10551

Abstract #

10551

Poster Bd #

45A

Abstract Disclosures