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. 2024 Feb 14:63:28-34.
doi: 10.2340/1651-226X.2024.23722.

Referral patterns of GIST patients: data from a nationwide study

Evelyne Roets  1 , Nikki S Ijzerman  2 , Vincent K Y Ho  3 , Ingrid M E Desar  4 , Anna K L Reyners  5 , Hans Gelderblom  6 , Dirk J Grünhagen  7 , Boudewijn Van Etten  8 , Winan J Van Houdt  9 , Winette T A Van der Graaf  10 , Neeltje Steeghs  1
Affiliations

Referral patterns of GIST patients: data from a nationwide study

Evelyne Roets et al. Acta Oncol. .

Abstract

Background: This study compares the characteristics, referral and treatment patterns and overall survival (OS) of gastrointestinal stromal tumor (GIST) patients treated in reference and non-reference centers in the Netherlands.

Patients and methods: This retrospective cohort study on patients diagnosed between 2016 and 2019, utilises data from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Database. Patients were categorized into two groups: patients diagnosed in or referred to reference centers and patients diagnosed in non-reference centers without referral.

Results: This study included 1,550 GIST patients with a median age of 67.0 in reference and 68.0 years in non-reference centers. Eighty-seven per cent of patients were diagnosed in non-reference centers, of which 36.5% (493/1,352) were referred to a reference center. Referral rates were higher for high-risk (62.2% [74/119]) and metastatic patients (67.2% [90/134]). Mutation analysis was performed in 96.9% and 87.6% of these cases in reference and in non-reference centers (p < 0.01), respectively. Systemic therapy was given in reference centers versus non-reference in 89.5% versus 82.0% (p < 0.01) of high-risk and in 94.1% versus 65.9% (p < 0.01) of metastatic patients, respectively. The proportion of positive resection margins and tumor rupture did not differ between reference and non-reference centers. Median OS was not reached.

Conclusion: A substantial amount of metastatic GIST patients in non-reference centers did not receive systemic treatment. This might be due to valid reasons. However, optimisation of the referral strategy of GIST patients in the Netherlands could benefit patients. Further research is needed to explore reasons for not starting systemic treatment in metastatic GIST patients.

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Conflict of interest statement

NS provided consultation or attended advisory boards for Boehringer Ingelheim, Ellipses Pharma. N Steeghs received research grants for the institute from AB Science, Abbvie, Actuate Therapeutics, ADCtherapeutics, Amgen, Array, Ascendis Pharma, Astex, AstraZeneca, Bayer, Blueprint Medicines, Boehringer Ingelheim, BridgeBio, Bristol-Myers Squibb, Cantargia, Celgene, CellCentric, Cresecendo, Cytovation, Deciphera, Eli Lilly, Exelixis, Genentech, Genmab, Gilead, GlaxoSmithKline, Incyte, InteRNA, Janssen/Johnson&Johnson, Kinate, Merck, Merck Sharp & Dohme, Merus, Molecular Partners, Novartis, Numab, Pfizer, Pierre Fabre, Regeneron, Roche, Sanofi, Seattle Genetics, Servier, Taiho, Takeda (outside the submitted work).

WvdG Advisory boards SpringworkTx, Agenus and PTC Therapeutics (all to the institute) and research grants from Eli Lilly (to the Institute).

All remaining authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Referral patterns of GIST patients.
Figure 2
Figure 2
Referral patterns according to the AFIP-Miettinen risk classification in patients treated with primary surgery (n = 1,006).
Figure 3
Figure 3
Overall survival in patients with high-risk GIST*. * Median OS was not reached.
Figure 4
Figure 4
Overall survival in patients with metastatic GIST*. * Median OS was not reached.
See this image and copyright information in PMC

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