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Selected Works of Sally Lord
Article
Development and validation of prognostic nomograms for metastatic gastrointestinal stromal tumour treated with imatinib
European Journal of Cancer (2015)
  • Chee Khoon Lee, The University of Sydney
  • David Goldstein, Prince of Wales Hospital
  • Emma Gibbs, The University of Sydney
  • Heikki Joensuu, Helsinki University Central Hospital
  • John Zalcberg, Monash University
  • Jaap Verweij, Erasmus University
  • Paolo Casali, Istituto Nazionale dei Tumori
  • Robert Maki, Mount Sinai School of Medicine
  • Angela Cioffi, Mount Sinai School of Medicine
  • Grant Mcarthur, Peter MacCallum Cancer Centre
  • Sally Lord, The University of Notre Dame Australia
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Abstract
Purpose: Metastatic gastrointestinal stromal tumour (GIST) is generally an incurable
disease with variable response to imatinib. We aimed to develop prognostic nomograms
to predict overall survival (OS) and progression-free survival (PFS) for patients treated with
imatinib.
Methods: Nomograms were developed in a training cohort (n = 330) of patients treated in a
randomised trial (EORTC-ISG-AGITG 62005 phase III study) using Cox regression models,
and validated in patients (n = 236) treated in routine clinical care from six referral centres.
Nomogram performance was assessed by calculating the c statistic. A classification based on
the nomograms’ scores was generated to group patients according to risk.
Results: Nomogram risk factors for OS and PFS were size of the largest metastasis, tumour
genotype, primary tumour mitotic count, haemoglobin and blood neutrophil count at commencement
of imatinib. The nomograms predicted survival with a c statistic of 0.75 (training)
and 0.62 (validation) for OS, and 0.69 (training) and 0.62 (validation) for PFS. When tested in
the validation cohort, the nomograms discriminated well the high and intermediate risk from
low risk patients (hazard ratio [HR] for OS 3.83, 95% confidence interval [CI] 1.71–8.56; and
2.48, 95% CI 1.12–5.50; for PFS 2.84, 95% CI 1.66–4.87; and 1.45, 95% CI 0.87–2.41, respectively).
Conclusion: The nomograms predicted the risk of GIST progression and death with good discrimination
of risk groups, and may be of value for patient counselling and risk stratification.
Disciplines
Publication Date
2015
DOI
10.1016/j.ejca.2015.02.015
Citation Information
Lee, C., Goldstein, D., Gibbs, E., Joensuu, H., Zalcberg, J., Verweij, J., Casali, P., Maki, R., Cioffi, A., Mcarthur, G., and Lord, S. (2015). Development and validation of prognostic nomograms for metastatic gastrointestinal stromal tumour treated with imatinib. European Journal of Cancer, 51(7), 852-860. DOI: 10.1016/j.ejca.2015.02.015