To Compare the Efficacy of Surgery Followed by Sunitinib With Surgery Followed by Imatinib in GIST Patients With Progression on Imatinib.

Study Overview
=================
Brief Summary
-----------------
To compare the efficacy of surgery followed by sunitinib with surgery followed by imatinib in GIST patients with progression on imatinib;To investigate the optimal therapy after surgery in GIST patients with focal or multifocal progression in imatinib

Detailed Description
-----------------
Primary Endpoint: To evaluate the progression free survival of the patients with progression receiving surgery followed by sunitinib therapy comparing with surgery followed by imatinib Secondary Endpoint：To evaluate the overall survival of the patients with progression receiving surgery followed by sunitinib therapy comparing with surgery followed by imatinib the relationship of c-kit secondary mutation and progression free survival of surgery followed by TKI therapy the safety and tolerability of the two therapy. Statistics:All the statistical analysis is performed using SPSS version 20.0 (IBM corporation, United States). Pearson's chi-squared test was used to compare categorical variables. PFS and OS analyses were estimated with Kaplan-Meier method and log-rank test and multivariable analyses were performed to assess survival difference. A two sided p-value of <0.05 was considered statistically significant.

Official Title
-----------------
A Retrospective Cohort Study

Conditions
-----------------
GIST

Intervention / Treatment
-----------------
* Drug: Imatinib 400mg
* Drug: Sunitinib 37.5Mg Oral Capsule


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: .Histopathological diagnosis of metastatic GIST. . After the treatment of imatinib, imatinib 400mg/day after treatment, the tumor generalized. . Patients with generalized progress were satisfied with tumor reduction after imatinib resistance for various reasons. at least 1 month after surgery for imatinib treatment or sunitinib treatment. at least one imaging assessment was received after surgery. . Complete clinical data and follow-up data. Exclusion Criteria: . Before operation, he was treated with sunitinib . Patients receiving tumor reduction were not satisfied with the standard of the reduction of tumor. . The treatment of imatinib or sunitinib after surgery was less than 1 month. . Incomplete clinical data or follow-up data.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Arm A<br>Imatinib 400 mg/day or 600mg/day, and within 6 weeks after surgery, continuous treatment was not tolerated until tumor progression, recurrence or adverse reactions were not tolerated. | Drug: Imatinib 400mg<br>* exposure 400 mg/day or 600mg/day,<br>|
| Arm B<br>Sunitinib 37.5 mg/day, continuous taking, or 50 mg/day (4/2), began within 6 weeks after surgery, and was continuously administered until tumor progression, recurrence or adverse reactions were not tolerated | Drug: Sunitinib 37.5Mg Oral Capsule<br>* exposure 37.5 mg/day, continuous taking, or 50 mg/day (4/2)<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Efficiency | The curative effect was evaluated by measuring the unprogression-survival (PFS) each treatment group. | 12 months | 
| Security | Clinical and laboratory toxicity/symptoms will be graded according to the nci-ctc toxicity criteria. | 12 months | 
| Molecular marker detection | Gene mutation of c-kit/PDGFRA of imatinib resistance | 12 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Sunitinib Imatinib