{"title":"Different outcomes by sex in metastatic gastrointestinal stromal tumor patients receiving imatinib: a trial-level analysis.","authors":"Antonella Venturino, Giuseppe Antonio Colloca","doi":"10.1007/s10147-025-02808-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Among gastrointestinal stromal tumors patients, many authors have reported longer overall survival for female sex regardless of stage. Other studies showed more favourable prognosis for young women, while others found no effect of sex on outcome. Few data about survival differences by sex are available on patients with unresectable/metastatic gastrointestinal stromal tumors (mGIST) receiving imatinib. The study aims to perform a trial-level analysis of metastatic gastrointestinal stromal tumors patients treated with imatinib to define the effect of sex on overall survival.</p><p><strong>Methods: </strong>After a systematic literature review, studies enrolling mGIST patients receiving upfront imatinib and reporting hazard ratios and confidence intervals of the relationship of sex with overall survival (OS) were selected. A meta-analysis was performed, calculating a global effect size. Finally, the study explored the effect on the relationship of other baseline variables, such as age, sex, tumor location, and patient origin.</p><p><strong>Results: </strong>Fifteen articles were selected, including 3612 patients. The meta-analysis documented longer OS among women, with significant overall effect size (HR 0.77, CI 0.71-0.84). Furthermore, there was no significant heterogeneity among studies (Q=9.13, p-value=0.8229; I<sup>2</sup>=0%), while the effect of the relationship was not confirmed for tumors originating in the stomach.</p><p><strong>Conclusions: </strong>The analysis documented better prognosis for female sex after upfront imatinib. The absence of heterogeneity between studies suggests that sex may condition a different response to imatinib. However, other factors, such as second malignancies and mutation patterns, may also contribute to the observed differences.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1797-1804"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02808-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Among gastrointestinal stromal tumors patients, many authors have reported longer overall survival for female sex regardless of stage. Other studies showed more favourable prognosis for young women, while others found no effect of sex on outcome. Few data about survival differences by sex are available on patients with unresectable/metastatic gastrointestinal stromal tumors (mGIST) receiving imatinib. The study aims to perform a trial-level analysis of metastatic gastrointestinal stromal tumors patients treated with imatinib to define the effect of sex on overall survival.
Methods: After a systematic literature review, studies enrolling mGIST patients receiving upfront imatinib and reporting hazard ratios and confidence intervals of the relationship of sex with overall survival (OS) were selected. A meta-analysis was performed, calculating a global effect size. Finally, the study explored the effect on the relationship of other baseline variables, such as age, sex, tumor location, and patient origin.
Results: Fifteen articles were selected, including 3612 patients. The meta-analysis documented longer OS among women, with significant overall effect size (HR 0.77, CI 0.71-0.84). Furthermore, there was no significant heterogeneity among studies (Q=9.13, p-value=0.8229; I2=0%), while the effect of the relationship was not confirmed for tumors originating in the stomach.
Conclusions: The analysis documented better prognosis for female sex after upfront imatinib. The absence of heterogeneity between studies suggests that sex may condition a different response to imatinib. However, other factors, such as second malignancies and mutation patterns, may also contribute to the observed differences.
背景：在胃肠道间质瘤患者中，许多作者报道了无论分期如何，女性患者的总生存期更长。其他研究显示，年轻女性的预后更好，而其他研究则发现性别对结果没有影响。在接受伊马替尼治疗的不可切除/转移性胃肠道间质瘤（mGIST）患者中，关于性别生存差异的数据很少。该研究旨在对接受伊马替尼治疗的转移性胃肠道间质瘤患者进行试验水平的分析，以确定性别对总生存期的影响。方法：经过系统的文献综述，选择纳入接受伊马替尼治疗的mGIST患者的研究，并报告性别与总生存期（OS）关系的风险比和置信区间。进行了荟萃分析，计算了整体效应大小。最后，研究探讨了其他基线变量（如年龄、性别、肿瘤位置和患者来源）对关系的影响。结果：入选文献15篇，患者3612例。荟萃分析显示，女性的生存期较长，总体效应显著（HR 0.77, CI 0.71-0.84）。此外，各研究间无显著异质性(Q=9.13， p值=0.8229；I2=0%)，而对于起源于胃的肿瘤，这种关系的影响尚未得到证实。结论：分析表明，女性患者在接受伊马替尼治疗后预后较好。研究之间缺乏异质性表明性别可能影响对伊马替尼的不同反应。然而，其他因素，如第二恶性肿瘤和突变模式，也可能导致观察到的差异。
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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