Phase II trial of neoadjuvant/adjuvant imatinib mesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST): Long-term follow-up results of RTOG 0132.

Wang, D.; Zhang, Q.; Blanke, Charles D.; Demetri, G. D.; Heinrich, M. C.; Watson, James C.; Hoffman, John P.; Okuno, Scott H.; Kane, J. M.; vonMehren, Margaret; Eisenberg, Burton L.

doi:10.1200/jco.2011.29.15_suppl.10057

Cited by 3 publications

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“…In this study, the proportion of patients who discontinued adjuvant imatinib for reasons other than GIST recurrence was 25.8% for patients in the 3-year group and 12.6% for patients in the 1-year group; this was expected, given the longer duration of treatment and observation [30]. In addition, imatinib at 600 mg per day for 2 years was well tolerated in a phase II study of neoadjuvant and adjuvant imatinib in patients with primary or metastatic and recurrent resectable GIST (Radiation Therapy Oncology Group 0132) [42,43].…”

Section: Safety and Tolerability Considerations During Long-term Contmentioning

confidence: 97%

Optimizing Tyrosine Kinase Inhibitor Therapy in Gastrointestinal Stromal Tumors: Exploring the Benefits of Continuous Kinase Suppression

et al. 2013

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Background. The oral tyrosine kinase inhibitor (TKI) imatinib has revolutionized the treatment of gastrointestinal stromal tumors (GISTs), most of which harbor oncogenic mutation in genes that encode the receptor tyrosine kinases KIT or PDGFA. Imatinib is the standard of care for patients with advanced GIST and for patients with primary GIST at significant risk of recurrence after surgery. Design. This review discusses data supporting continuous kinase suppression with imatinib and key issues, including response to imatinib reintroduction, effect of treatment interruption on secondary resistance to imatinib, and prognostic factors associated with sustained response to imatinib. Results. Long-term follow-up results of the B2222 study and updated results of the BFR14 trial demonstrate that continuous imatinib treatment in patients with advanced GIST is associated with reduced risk of progression. For patients progressing on or intolerant of imatinib, continuing therapy with TKIs sunitinib followed by regorafenib is recommended. In the adjuvant setting, final results of the trial by the Scandinavian Sarcoma Group and the Sarcoma Group of the Arbeitsgemeinschaft Internistische Onkologie demonstrate that 3 years of adjuvant imatinib, compared with 1 year, significantly reduces the risk of recurrence and improves overall survival of patients with KIT-positive GIST at high risk of recurrence. Conclusions. Maintenance of therapy with TKIs is the key to successful treatment of GIST. Results from recent studies provide a strong rationale for continuous imatinib treatment for 3 years following surgical resection and long-term continuous administration in advanced or metastatic GIST. The Oncologist 2013;18:1192-1199 Implications for Practice: Imatinib interruption in advanced setting results in rapid progression in the vast majority of patients and should not be recommended outside clinical trials unless patients experienced significant toxicity. The results observed in advanced GIST need to be considered also for the use of imatinib in the adjuvant setting where the optimal duration of imatinib is unknown (at least three years) and where reintroduction of imatinib is the standard of care in case of disease recurrence.

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Section: Safety and Tolerability Considerations During Long-term Contmentioning

confidence: 97%