tbuckley/cabot-search huggingface dataset:
Prognostic factors impacting survival in early HER2-positive breast cancer (BC): Results from a 1,142 patients database study.
Authors: Roberto Hegg, Andre Mattar, Maurício Rocha, Renato Watanabe Oliveira, Guilherme Silva Julian, Luiz Henrique Gebrim
Journal: Journal of Clinical Oncology (2020)

e12561 Background: early systemic therapy has reduced recurrence and mortality from BC, especially among HER2+ subtype. Despite these advances, the difficulty of developing countries in incorporating new treatments, as well as the molecular and phenotypic profiles of HER2+ BC, are associated with the heterogeneity of treatment responses, leading to poor prognosis and outcomes. However, real-world data on prognostic factors for early HER2+ BC patients are scarce, especially in the Brazilian context. Therefore, this study aims to evaluate the influence of prognostic factors on disease-free survival (DFS) and overall survival (OS) in early HER2+ BC patients. Methods: this retrospective study identified early HER2+ BC (stage I to III with positive immunohistochemistry and in-situ hybridization) patients from Pérola Byington’s public hospital database (São Paulo, Brazil) diagnosed between January 2010 to March 2018. Patients were excluded if they were less than 18 years old, participated in clinical trials, presented metastatic disease de novo, concurrent malignancy, or inconsistent data. Multivariate Cox regression was used to evaluate prognostic factors for survival, and OS and DFS were estimated by Kaplan-Meier analyses. Results: of the 1,625 patients identified in the database, 1,142 women were included in the study. Of those, 40% were diagnosed with less than 50 years old. Among the included patients, 40.3% were HR-/HER2+ and 59.7% were HR+/HER2+. In addition, 19.4% of patients were diagnosed at stage I, 42.9% at stage II and 37.7% at stage III. A total of 1033 patients were included in the DFS analysis, with a probability of 71.8% DFS in 5-years. For OS analysis, a probability of 75.4% OS in 5-years was observed for 1139 patients included. The multivariate analysis showed that tumor staging, lymph node involvement and pathological complete response (pCR) were independent prognostic factors for both DFS and OS. Conclusions: the study in the Brazilian cohort corroborates the literature, showing that tumor staging, pCR, and lymph node involvement are key markers for DFS and OS and they should be considered when managing the early HER2+ BC patients. [Table: see text]
Effectively implementation of prevention and control for novel coronavirus infections in primary care
Authors: Chunhua Chi, Hao Wu, Ting Yang, Chen Wang
Journal: BMJ (2020)

为强化和规范基层新型冠状病毒感染的防控工作，由中华医学会、中国医师协会相关专业分会的专家联合制订了《新型冠状病毒感染基层防控指导意见（第一版）》，从基层医疗卫生机构防控规范、普通人群防控规范、特殊人群防控规范、科普宣教、信息技术应用等方面给予了详细的指导。旨在促进基层医疗卫生机构和基层医务人员在抗击新型冠状病毒感染疫情阻击战中，承担起居民健康守门人的职责，扎扎实实做好科学有效的防控工作，从根本上保障全民健康。
Impact of individualized diabetes education on disease awareness and blood glucose control in type 2 diabetic patients
Authors: Jia-ying Wang, Hui-qin Zhang, Jing-jing Xue, Min Cheng, Xiang Li, Man Wu
Journal: BMJ (2008)

This study was to evaluate the effect of individualized health education on blood glucose control in type 2 diabetic(T2D)Patients.Two hundred and thirty-eight T2D patients were randomly received individualized diabetes education(intervention group)or general education(control group).At 48 week,change of blood glucose control from baseline was observed.The blood glucose level and HbA1c in the intervention group were lower than those in the control group[(7.1±0.8)vs (9.3±6.5)mmol/L,(7.0 ±1.3)%vs(8.0%±1.0)%;P＜0.05].Thus,individualized diabetes education might be helpful for blood glucose control in T2D patients.

Key words: 
Diabetes mellitues,2 type; Patient education
门诊乳腺区段手术三种局部麻醉方法的比较
Authors: 卢毅卓, 罗琪, 李智, 蔡仲达, 刘小村, 谢尚锦
Journal: BMJ (2007)

对90例在门诊行乳腺区段手术治疗的患者分别采用局部浸润、乳腺后间隙局部区域阻滞、肋间神经阻滞3种方法的局部麻醉(各30例),比较其麻醉效果及安全性.肋间神经阻滞麻醉实施时间最短;乳腺后间隙局部区域阻滞麻醉镇痛时间最长,注射麻醉药物量最大,优秀麻醉例数最多,为25例.说明3种局部麻醉方法在安全和效果方面各有优缺点,应依患者情况个体化选择和处理。
Value of noneinvasive vascular examinations in diagnosing deep venous thrombosis
Authors: Yu-ya Zhang, Qing-hua Wu, Zhong Chen, Pei Yang, Han Zhou
Journal: BMJ (2008)

Objective To evaluate the different value of color Doppler ultrnsonography and Doppler vascular examinations in diagnosis for deep venous thrombosis(DVT)in the lower extremities.Methotis Imaging of color Doppler ultrasound scanning was employed as diagnostic criteria for DVT on 178 lower extremities of 146 suspected patients,as compared to the result by Doppler vascular examinations.Results Color Doppler ultrasonograph showed hish accuracy in diagnosis for DVT,as compared to that by Doppler vascular examination with 97.9 percent(142/145)positive for the femoral and popliteal veins and relatively lower positive diagnostic vallie for thrombosis in the inferior vena cava,iliac vein,anterior tibial vein,posterior tibial vein and calf veins.Conclusions Color Doppler ultrasonography is superior to Doppler vascular examination in determining DVT of the lower extremities and can be used as a main diagnostic method for it.Doppler vasculiar examination can be used as an initial screening method for DVT and deep venous angiography should not be used as a routine diagnostic measure for it.

Key words: 
Utrasonography,Doppler,color; Peripheral vascular disease; Lower extremity; Venous thrombosis
Physiologic colonic uptake of <sup>18</sup>F-FDG on PET/CT predicts immunotherapy response and gut microbiome diversity in patients with advanced non-small cell lung cancer (NSCLC).
Authors: Lena Cvetkovic, Claudine Régis, Valerio Iebba, Lisa Derosa, Antoine Leblond, Julie Malo, Meriem Messaoudene, Wiam Belkaid, Arielle Elkrief, Bertrand Routy, Daniel Juneau
Journal: Journal of Clinical Oncology (2020)

9600 Background: Immune checkpoint inhibitors (ICI) represent the backbone treatment of advanced non-small cell lung cancer (aNSCLC) patients. Emerging evidence suggests increased gut microbiome (GM) diversity is associated with favorable response. Conversely, antibiotic-induced dysbiosis may be associated with deleterious outcomes in patients receiving ICI in multiple retrospective studies and one prospective study. 18 F-FDG physiologic colonic uptake on PET/CT increases following treatment with antibiotics and could be a surrogate marker for GM diversity and therefore clinical response. The aim of this study was to determine if 18 F-FDG physiologic colonic uptake prior to ICI initiation correlates with outcomes and GM metagenomics in patients with advanced NSCLC. Methods: 71 patients with aNSCLC who underwent PET/CT prior to ICI were identified. For each patient, the colon was manually contoured, SUVmax was measured in each segment of the colon by a nuclear medicine specialist and average SUVmax was calculated for the whole colon. Patients were stratified in two groups according to median colon SUVmax (low vs high uptake). 18 F-FDG physiologic colonic uptake was then compared to overall survival (OS), objective response (ORR), and progression-free survival (PFS). For patients with available stool samples (n = 10), GM composition was defined using metagenomics sequencing. Results: 71 patients (54% men, median age: 68 years) with aNSCLC were included in the study and ICI was the first line of therapy in 38% of those patients. The mean colon SUV for the low and high uptake groups were 1.41 (CI 95% 1.35-1.47) and 2.18 (CI 95% 1.90-2.46) respectively. The high uptake group had a higher proportion of non-responders (p = 0.033) and significant shorter PFS (4.1 months vs 11.3 months, p = 0.005). In the caecum, high uptake also correlated with numerically shorter OS (10.82 vs 27.56 months, p = 0.058) compared to low uptake group. Despite the low number of samples, metagenomics sequencing revealed that PLS-DA (Partial Least Squares Discriminant Analysis) for diversity was lower in the high SUV group (p = 0.008). Conclusions: Higher colon SUVmax on pre-ICI FDG PET/CT is associated with worse clinical outcomes and lower baseline GM diversity in patients with advanced NSCLC. Here, we propose that 18 F-FDG physiologic colonic uptake on PET/CT could serve as a surrogate marker of GM diversity and predicts clinical outcomes.
不仅仅是科学
Authors: 吴东
Journal: BMJ (2012)

科技是医学的重要元素,但并非医学的全部,更不是医学的本源.对人类病痛感同身受的理解,以及由此催生的热情、专注、慈悲和自省,才是医学诞生和发展的恒久动力.越是在科学技术日新月异的今天,越要强调医学的人文性,越要提升医务工作者人文素养.老一辈医学家如林巧稚教授,通过她数十年的言传身教,为我们树立了永远的榜样。
Prevention and treatment of chronic complications of diabetes mellitus for primary care physicians
Authors: Tianfeng Wu
Journal: BMJ (2017)

糖尿病慢性并发症多、致残致死率高，而早期诊断及干预可减少包括心肌梗死、脑卒中、下肢截肢、终末期肾病、失明等糖尿病慢性并发症的发生。随着我国慢病分级诊疗的实施，基层全科医生在对糖尿病患者进行规范降糖治疗的同时，应进行糖尿病慢性并发症的筛查，以期早发现、早治疗。
An investigation and analysis for dietary nutrition in bedridden elderly patients
Authors: Chun Wang
Journal: BMJ (2011)

In total, 607 bedridden patients aged 60 years and over at Tianlin community hospital and four other hospitals or at home-care in Shanghai were investigated with questionnaire, physical examinations and related laboratory tests. Contents of investigation include general situation, medical conditions, 24-hour recall of diet, intake of nutritional supplement preparation, and so on. As compare to the reference for nutrient intake of the elderly set in the Guide to Diet for Chinese Residents (2007), total nutritional intake was obviously insufficient and three nutrients in diet were imbalanced for most bedridden elderly patients. Intake of most nutrients (including proteins, dietary fiber, calcium, iron, zinc, selenium,copper, magnesium, phosphor, retinol equivalent, vitamin B1 , vitamin B2, vitamin C) was obviously low in bedridden elderly patients, with a larger gap from the requirements of the Dietary Guide.

Key words: 
Nutrition survey;  Questionnaire
Response to neoadjuvant chemotherapy and the 21-gene breast recurrence score in young women with estrogen receptor-positive early breast cancer.
Authors: Tal Sella, Shari I. Gelber, Philip Daniel Poorvu, Hee Jeong Kim, Yaileen D Guzman Arocho, Laura C. Collins, Kathryn Jean Ruddy, Rulla M Tamimi, Jeffrey M. Peppercorn, Lidia Schapira, Virginia F. Borges, Steven E. Come, Ellen Warner, Craig Snow, Debbie M Jakubowski, Christy Ann Russell, Eric P. Winer, Shoshana M. Rosenberg, Ann H. Partridge
Journal: Journal of Clinical Oncology (2020)

514 Background: The 21- gene Breast Recurrence Score predicts benefit from adjuvant chemotherapy in estrogen receptor positive (ER+), HER-2 negative (-) breast cancer (BC). We aimed to examine whether the 21-gene assay predicts response to neoadjuvant chemotherapy (NAC). Methods: We identified patients with stage I-III ER+/HER2− BC treated with NAC from the Young Women's Breast Cancer Study, a prospective cohort of women diagnosed with BC at age ≤ 40 years. The 21-gene assay was performed on tumor specimens removed prior to NAC either as part of clinical care or retrospectively for research. Pathologic complete response (pCR) was defined as no residual invasive tumor (ypT0/is ypN0). The relationship between Recurrence Score result (RS) and pCR was evaluated using logistic regression modeling. Results: 76 women in the cohort had undergone NAC for ER+, HER2- BC and were eligible for this analysis: 5 had undergone clinical 21-gene assay testing, 71 had banked specimens retrospectively tested. Median age at diagnosis was 36.7 (24.3-40). Most tumors were of ductal histology (78%), high grade (51%), progesterone receptor (PgR) positive (86%), ≥T2 (88%), clinically node positive (74%), and anthracycline and taxane containing protocols were administered in 86% of cases. RS ranged between 5-75 with 50% &gt; 25 and only 4 &lt; 11. Mean RS was significantly higher among tumors achieving pCR vs. non-pCR response (51.9 vs. 26.6, p wilcoxon = 0.0005). pCR rate in patients with RS &gt; 25 was 21% (8/38) vs. 5% in patients with RS &lt; 25 (2/38), with both pCRs in the &lt;25 group in patients with RS 21-25. In univariable analysis, PgR negativity (odds ratio (OR) 5.62, 95% confidence interval (CI) 1.27-24.89, p = 0.02), high grade (OR 9.03, 95%CI 1.07-76.32, p = 0.04) and higher RS as a continuous variable (OR 1.08, 95%CI 1.04-1.13, p = 0.0003) were associated with a greater likelihood of pCR. In multivariable analysis only RS remained significantly associated with pCR (OR: 1.07, 95%CI 1.01-1.12, p = 0.01): a 7% increase in the odds of pCR for every 1-point increase in RS. Conclusions: In young women with ER+, HER2- BC who received NAC, higher pretreatment RS was associated with an increased likelihood of pCR. Genomic expression profiling assays may have a role in decision-making in young women in need of neoadjuvant therapy. For women with low likelihood of benefiting from NAC, alternative approaches are clearly warranted. Given the demonstrated efficacy of neoadjuvant endocrine therapy in post-menopausal women, further evaluation in young women should be pursued.
Interplay of somatic alterations and immune infiltration modulates response to PD-1 blockade in advanced clear cell renal cell carcinoma
Authors: David A. Braun, Yue Hou, Ziad Bakouny, Miriam Ficial, Miriam Sant’ Angelo, Juliet Forman, Petra Ross-Macdonald, Ashton C. Berger, Opeyemi A. Jegede, Liudmilla Elagina, John Steinharter, Maxine Sun, Megan Wind-Rotolo, Jean-Christophe Pignon, Andrew D. Cherniack, Lee Lichtenstein, Donna Neuberg, Paul Catalano, Gordon J. Freeman, Arlene H. Sharpe, David F. McDermott, Eliezer M. Van Allen, Sabina Signoretti, Catherine J. Wu, Sachet A. Shukla, Toni K. Choueiri
Journal: Nature Medicine (2020)
急性下壁伴或不伴右室心肌梗死患者的临床特点分析
Authors: 詹中群, 王崇全, 党书毅, 王玮, 王俊峰
Journal: BMJ (2005)

比较下壁合并右室心肌梗死(34例)和单纯下壁心肌梗死患者(58例)在主要危险因素、临床表现、治疗和并发症方面的差别,结果示下壁合并右室心肌梗死患者出现低血压、颈静脉怒张和Kussmaul征的比例明显增加,且更多地需要容量负荷维持血压和应用正性肌力药物维持血压(均P=0.001),并有较高的死亡率(P=0.039)。
Phase II study of copanlisib in patients with tumors with <i>PIK3CA</i> mutations (<i>PTEN</i> loss allowed): NCI MATCH EAY131-Z1F.
Authors: Senthil Damodaran, Fengmin Zhao, Dustin A. Deming, Edith P. Mitchell, John Joseph Wright, Laurence A Doyle, Robert James Gray, Shuli Li, Lisa McShane, Larry V Rubinstein, David R Patton, Mickey Williams, Stanley R. Hamilton, Jennifer Marie Suga, Barbara A. Conley, Carlos L. Arteaga, Lyndsay Harris, Peter J. O'Dwyer, Alice P. Chen, Keith Flaherty
Journal: Journal of Clinical Oncology (2020)

3506 Background: The NCI-MATCH (EAY131) is a platform trial that enrolls patients (pts) with solid tumors, lymphomas, or multiple myeloma to targeted therapies based on matching genomic alterations of interest (NCT02465060). Arm Z1F evaluated copanlisib, a highly selective, pan-Class 1 PI3K inhibitor with predominant activity against both the δ and α isoforms in pts with PIK3CA mutations. Methods: Pts received copanlisib (60 mg IV) on days 1, 8, and 15 in 28-day cycles until progression/toxicity. Tumor assessment was every 2 cycles. The primary endpoint was objective response rate (ORR); secondary endpoints were PFS, 6-month PFS, and predictive biomarkers. Pts with KRAS mutations, HER2+ve breast cancers, lymphomas were excluded. Results: 35 pts were enrolled (from 8/2/18 to 12/27/18), of which, 28 pts were available for analysis (7 patients, not eligible or did not start therapy). Multiple histologies were enrolled with gynecologic (n = 7), gastrointestinal (n = 6), and genitourinary (n = 5) the most common tumors. Median age 61 (range 42-78). 75% of pts had ≥ 3 lines of prior therapy. 54% of PIK3CA mutations were located in the helical domain, 32% in kinase domain and 14% in other domains. Twenty-six pts had co-occurring gene alterations (median 3; range 1-9), with 9 patients having 4 or more gene alterations. The ORR was 11% (3/28, 90% CI: 3%-25%). Partial responses were seen in uterine cancer, clear cell carcinoma of anterior abdominal wall, and liposarcoma. 6 pts had &gt; 6 months of stable disease and clinical benefit rate was 32% (9/28). Two pts are still on treatment. The most common reason for protocol discontinuation was disease progression (n = 18, 69%). Thirty pts were included for toxicity analysis. Ten pts (33%) had grade 1 or 2 toxicities, 16 pts (53%) had grade 3 toxicities, and one patient (3%) had grade 4 toxicity (CTCAE v5.0). Most common toxicities include hyperglycemia (n = 19), fatigue (n = 11), hypertension (n = 10), diarrhea (n = 10), and nausea (n = 9). Total of 5 deaths were reported, none related to treatment. Conclusions: Copanlisib showed meaningful clinical activity across various tumors with PIK3CA mutation in the late-line refractory setting. Further study either alone or in combinations in select tumors is warranted. G3/4 toxicities observed were consistent with reported toxicities for PI3K pathway inhibition. Clinical trial information: NCT02465060 .
Real-world outcome with abiraterone low-dose plus prednisone in patients with mCRPC in a Brazilian Public Cancer Center.
Authors: Luis Eduardo Rosa Zucca, Joao Antonio Junior Neif, Daniel D Almeida Preto, Isadora Clarissa Cordeiro Dias, Hadson Silva Araujo, Flavio Mavignier Carcano
Journal: Journal of Clinical Oncology (2020)

e17563 Background: Abiraterone acetate (AA) is a potent selective and irreversible inhibitor of CYP17 used as standard treatment for metastatic Castration Resistant Prostate Cancer (mCRPC). In the pivotal trial COU-AA 301, AA 1000 mg/day plus prednisone increased overall survival after docetaxel in patients with mCRPC. A recent trial demonstrated not inferiority with respect to PSA metrics in the reduced dose of 250mg/day AA associated with dietary intake, which is described as AA low dose (AALD). The introduction of generic AA in the Brazilian Pharma Market and after the endorsement of AALD from international guidelines, the use of AA in limited resourced hospitals became feasible. Since december 2018 our institution has incorporated AALD in patients with mCRPC in first or second line therapy, always after chemotherapy with Docetaxel (either in the sensitive or castration scenario). Methods: We retrospectively reviewed 49 patients with mCRPC that received AALD after chemotherapy with Docetaxel from December 2018 to January 2019. The primary end point was PSA response rate (decrease of ≥ 50% in the PSA concentration from pretreatment PSA value). Univariable analysis were performed to explore association between clinical and pathological features. Results: After a median follow-up of 5 months, 25 patients (51%) had PSA response rate ≥ 50%. Median age was 69 years-old and most patients (73.5%) were ECOG 0 and 1. Despite good ECOG, the population had aggressive disease characteristics with 57.1% being ISUP 4 and 5 and 69.4% being clinical stage IV at initial diagnosis. Seventeen patients (34.7%) were exposed to AALD at first line and 32 patients (65.3%) in second line. It was observed that patients in the first line had better PSA response rate them those treated in the second line (70,6% vs 40,6%. p 0.04). Conclusions: Despite the premature data, this retrospective analyses shows PSA response rate in about 50% of patients treated with AALD in the overall population and about 70% in those treated in first line therapy. Serum PSA response rate is known as a surrogate marker for overall survival in those patients. The protocol will for more mature data. AALD might be an alternative dose for treating patients in institutions with limited resources.
Prognostic similarities between gastric adenosquamous carcinoma and typical gastric adenocarcinoma: A large population-based and propensity score-matched study.
Authors: Feng Zhao, Jili Wang, Xiaofei Cheng, Xinke Li, Zhongjie Lu, Xin Chen, Senxiang Yan
Journal: Journal of Clinical Oncology (2020)

e16559 Background: Gastric adenosquamous carcinoma (ASC) is an extremely rare form of stomach malignancy. To date, the limited knowledge of its biology and outcomes stems from mostly small, single institution experiences. We analyzed the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016 to explore the treatment of ASC together with its prognostic factors to gain relatively large and consolidated insights. Methods: Propensity score matching (PSM) and Kaplan–Meier analyses were used to compare the prognosis between gastric ASC and typical gastric adenocarcinoma (AC). We assessed overall survival (OS) after patient stratification according to summary stage and treatment choice. Cox hazards regression analysis was performed to determine independent predictors of overall survival (OS). Results: A total of 171 gastric ASC were included (mean 65.20 ± 11.71 years-of-age). Patients with gastric ASC had similar OS to matched individuals with typical gastric AC (p = 0.915). In terms of treatment, 45.6% of gastric ASC patients underwent surgery, and 37.4% received radiotherapy (RT), and 64.3% received chemotherapy. Patients who underwent surgery had longer OS than those who did not receive surgery (p &lt; 0.001), patients who received radiation therapy had longer OS than those who did not receive RT (p &lt; 0.001), and patients who received chemotherapy had longer OS than those who did not receive chemotherapy (p &lt; 0.001). A multivariate Cox analysis for OS showed that distant stage (HR, 3.334, 95% CI 1.544-7.199; p &lt; 0.01) was independent prognostic factors for gastric ASC. Conclusions: Analysis of its outcomes indicates that gastric ASC is not a more malignant tumor as previously suspected. Gastric ASC shows a similar prognosis to typical gastric AC. Surgery, RT, and chemotherapy was associated with prolonged OS. Distant stage was associated with poor OS.
We couldn’t resist comparing central with local RECIST1.1 and with Choi assessment: Exploratory analysis of tumor imaging in EORTC STBSG Phase 2 trial 1317 “CaboGIST.
Authors: Anastasios Kyriazoglou, Pieter Jespers, Vincent Vandecaveye, Olivier Mir, Bernd Kasper, Zsuzsanna Papai, Jean-Yves Blay, Antoine Italiano, Facundo Zaffaroni, Saskia Litiere, Axelle Nzokirantevye, Patrick Schoffski
Journal: Journal of Clinical Oncology (2020)

e23563 Background: Gastrointestinal stromal tumor (GIST) is commonly driven by activating mutations in KIT or PDGFRA. Advanced GIST is treated with tyrosine kinase inhibitors (TKIs) but develops resistance over time. EORTC 1317 assessed the safety and activity of cabozantinib, a multi-TKI targeting KIT, MET, AXL and proangiogenic pathways, in GIST patients who had progressed on imatinib and sunitinib. The efficacy analysis of the trial, which met its primary endpoint, was based on local assessment of RECIST1.1 response. RECIST neglects myxoid degeneration, necrosis and vascular remodeling induced by TKIs without major volumetric changes. Density changes on CT scans can predict clinical benefit and can be assessed by Choi criteria. Methods: We describe results of a post hoc exploratory analysis of CT scans performed centrally using RECIST 1.1 and Choi criteria. Results: Week 12 scans were available and evaluable by central review in 43 pts, Choi in 42 cases. Comparisons between local and central RECIST1.1 outcome revealed discrepancies in 17/43 evaluable cases (39.5%). When comparing Choi with local and central RECIST1.1 at week 12, discrepancies were observed in 27/42 (64.3%) and 21/42 (50%) evaluable cases, respectively. In summary, 70% of evaluable patients were progression-free and alive at week 12 based on local assessment, 86% and 83% according to central RECIST1.1 and Choi criteria, respectively. The main difference was the rate of objective response with cabozantinib in week 12: 5 PR (12%) with local RECIST1.1, 3 PR (7%) with central assessment, and 21 PR (50%) with Choi criteria. Conclusions: RECIST1.1 remains an unsatisfactory tool for response assessment in GIST, illustrated by the high inter-rater variability of response outcome comparing local versus central analysis. RECIST1.1 clearly underestimates the anti-tumor activity of TKIs in GIST. Cabozantinib did not only meet the primary endpoint of this trial when applying RECIST1.1 per protocol, but achieved objective responses in 50% of evaluable patients in week 12 when using Choi criteria. [Table: see text]