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Utilization of Mutational Analysis (MA) in Gastrointestinal Stromal Tumor (GIST) Management in British Columbia (BC) Between January 2008 to December 2017: a Retrospective Population-Based Study

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Abstract

Purpose

To examine oncologists’ practice pattern of ordering MA in localized and metastatic GISTs in British Columbia (BC).

Methods

Patients diagnosed with GIST from January 2008 to December 2017 in BC were identified. Chart review was performed to determine clinical characteristics and the use of MA as part of their oncologic care.

Results

The cohort included 411 patients: median age 64 (18–94 years), 49.1% male, primary site included stomach (53%), small intestine (32%), and others (15%). Sixty-nine percent had localized disease, while 13% presented with de novo metastatic disease and 18% had recurrent metastatic disease. MA was ordered in 41% of the patients overall, 28% in localized, and 70% in metastatic settings (63% in de novo metastasis and 78% in recurrent metastasis). Among patients with localized disease, higher MA use rates were observed among those undergoing neoadjuvant/adjuvant treatment (45%) compared to those not receiving systemic therapy (18%). While MA use rates in localized GIST did not change over time (28.5% before 2015 and 28% after 2015), MA use in metastatic disease increased from 54% before 2015 to 79% after 2015. Among all MA ordered for metastatic disease, 82.4% were ordered at the time of de novo metastatic diagnosis, and 77.4% were ordered either at the time of recurrent metastatic diagnosis or earlier when the disease was localized.

Conclusion

MA use has remained stable for localized disease but has increased after 2015 in the metastatic setting which may be due to evolving sequencing technology, expansion of metastatic treatment options, and enhanced awareness of MA.

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Acknowledgements

We sincerely thank all patients and sarcoma physicians at BC Cancer and across 15 academic cancer centers in Canada who participated in this study and Colleen Wong and colleagues in BC Cancer Surveillance and Outcome and BC Cancer Sarcoma Outcome Unit.

Funding

We received a Glenita Mungcal GIST research award from Sarcoma Life Raft Group Canada to help support this research work.

Author information

Author notes

  1. Tiffany Patterson, Jocelyn Chai and Haocheng Li contributed equally.

Authors and Affiliations

  1. Clinical Trials, BC Cancer – Vancouver Island Center, Victoria, BC, Canada

    Tiffany Patterson & Phil Pollock

  2. Department of Medicine, University of British Columbia, Vancouver, BC, Canada

    Jocelyn Chai

  3. Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada

    Haocheng Li

  4. Department of Medicine, Island Medical Program, University of British Columbia, Victoria, BC, Canada

    Angeline de bruyns & Chantell Cleversey

  5. Department of Pathology and Laboratory Medicine, Vancouver General Hospital, University of British Columbia, BC Cancer – Vancouver Centre, Vancouver, BC, Canada

    Cheng-Han Lee & Steven Yip

  6. Department of Medical Oncology, University of British Columbia, BC Cancer—Vancouver Center, Vancouver, BC, Canada

    Christine Simmons

  7. Department of Medical Oncology, University of British Columbia, BC Cancer—Vancouver Island Center, Victoria, BC, Canada

    Jason Hart & Xiaolan Feng

  8. Department of Radiation Oncology, University of British Columbia, BC Cancer—Vancouver Island Center, Victoria, BC, Canada

    Caroline Holloway & Pauline Truong

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  1. Tiffany Patterson
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Contributions

C.H.L, C.S., C.H., P.T., and X.F. conceived and designed the study. T.P., J.C., H.L, P.T., and X.F. wrote the manuscript with additional text and feedback from all authors. T.P., J.C., H.L, A.D., C.C., and X.F. performed the data collection and analysis. C.H.L., S.Y., C.S., and X.F. supervised the data generation. J.H., P.P., C.H., P.T., and X.F. supervised the project.

Corresponding author

Correspondence to Xiaolan Feng.

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Ethics Approval

This study was approved by the University of British Columbia Research Ethics Board (REB# H19-02339).

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The authors declare no competing interest.

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Patterson, T., Chai, J., Li, H. et al. Utilization of Mutational Analysis (MA) in Gastrointestinal Stromal Tumor (GIST) Management in British Columbia (BC) Between January 2008 to December 2017: a Retrospective Population-Based Study. J Gastrointest Canc 53, 709–717 (2022). https://doi.org/10.1007/s12029-021-00682-2

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