Time to secondary resistance (TSR) after interruption of imatinib (IM) in advanced GIST: Updated results of the prospective French Sarcoma Group randomized phase III trial on long-term survival.

Cesne, Axel Le; Ray-Coquard, I. L.; Nguyen, Binh Bui; Adenis, Antoine; Rios, María; Bertucci, François; Duffaud, Florence; Cupissol, Didier; Chevreau, Christine; Bompas, Emmanuelle; Cioffi, A.; Chabaud, Sylvie; Pérol, David; Blay, J-Y.

doi:10.1200/jco.2011.29.15_suppl.10015

Cited by 15 publications

(15 citation statements)

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“…In one study, patients free from progression after 1, 3, or 5 years of imatinib were randomly assigned to continue or interrupt therapy. 59 Progression-free survival was significantly lower in the group of patients who had their therapy interrupted. This study is not an adherence study per se but rather a study that demonstrates adverse outcomes associated with interrupting imatinib therapy in patients with GIST.…”

Section: Other Malignanciesmentioning

confidence: 95%

“…Two recent studies evaluated the adherence of patients with GI stromal tumors (GIST) receiving imatinib. In one study, patients free from progression after 1, 3, or 5 years of imatinib were randomly assigned to continue or interrupt therapy . Progression‐free survival was significantly lower in the group of patients who had their therapy interrupted.…”

Section: Studies Of Adherence To Oral Cancer Therapiesmentioning

confidence: 99%

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Improving Adherence to Oral Cancer Therapy in Clinical Practice

2014

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Adherence to oral chemotherapy regimens maximizes their effectiveness and minimizes any potential toxicities. Factors specifically related to the treatment, patient, and health care provider may influence medication adherence. Treatment‐related factors include the complexity of the regimen, the cost of therapy, the possibility of side effects, and the delay in treatment benefits. Meanwhile, patients may not have an adequate support system or an understanding of the need for the medication, and providers may not fully succeed in communicating the importance of adherence and the types of side effects that may occur. Nonadherence may lead to an increased risk of toxicity, decreased effectiveness, and increased utilization of health care resources. Although various methods for measuring adherence are available, self‐reporting is the most widely used. Studies describing adherence in a broad range of cancers are reviewed. Treatment of chronic myeloid leukemia has been revolutionized by the development of oral tyrosine kinase inhibitors that are highly effective in managing the disease when taken consistently. However, nonadherence is relatively common and can lead to reduced rates of response and increased medical costs. Similar effects of nonadherence on outcome and cost have also been observed in patients with various other hematologic malignancies and solid tumors. Interventions to improve adherence to oral chemotherapy regimens include communication about the importance of adherence and the potential consequences of nonadherence, simplification of the patient's medication schedule (if possible), and inclusion of a caregiver or family member in the conversation. Written materials should always be provided to accompany verbal instructions. This review summarizes factors influencing medication adherence, impact of nonadherence on patient outcomes, methods for measuring adherence, previous studies of nonadherence in patients with cancer, common barriers to access, and interventions to improve adherence in the community setting.

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Section: Other Malignanciesmentioning

confidence: 95%

Section: Studies Of Adherence To Oral Cancer Therapiesmentioning

confidence: 99%

Improving Adherence to Oral Cancer Therapy in Clinical Practice

2014

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“…The French BFR14 trial addressed the question of imatinib dosing interruption in metastatic GISTs following initial disease controls after 1, 3, and 5 years of daily treatment with 400 mg of imatinib in non-progressive patients who have not yet developed progressive disease. In patients randomized to stop imatinib dosing, the median PFS after initial disease control of 1, 3, or 5 years was quite short (only 7, 9, or 13 months, respectively); in comparison, the patients randomized to continue imatinib dosing continued to maintain disease control with a median PFS of 29 months for the group randomized after the first year of disease control, and median PFS was much longer and not reached at the time of the report in patients randomized after 3 or 5 years of disease control 16 – 18 . Although the majority of patients who progressed after dosing interruption were able to regain control of the progressive disease, a small number of patients had continuation of progression, and this led to the standard of care to avoid lengthy dosing interruptions of imatinib in patients with disease stability or response.…”

Section: Advanced and Metastatic Gist Managementmentioning

confidence: 99%

Recent advances in managing gastrointestinal stromal tumor

Duffaud

Cesne

2017

F1000Res

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Constitutive activating mutations in KIT and platelet-derived growth factor receptor α ( PDGFRα) are heavily involved in the pathobiology of gastrointestinal stromal tumors (GISTs). This disease has served as an effective “proof-of-concept” model for targeting gain-of-function kinase mutations in cancer. This review discusses the current standard of care in terms of pharmacotherapy in the management of localized and metastatic GISTs.

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“…33,34 Tumor control was restored following imatinib re-challenge at the same dose as that received prior to cessation of imatinib therapy. 33,35 These results clearly suggest that the interruption of imatinib, even after 5 years of therapy, results in almost universal progression of controlled lesions.…”

Section: Clinical Benefit Of Continuous Imatinib Therapy In Advanced mentioning

confidence: 99%

Dose optimization of tyrosine kinase inhibitors to improve outcomes in GIST

Zalcberg¹,

Desai²

2012

Asia-Pac J Clncl Oncology

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Tyrosine kinase inhibitors such as imatinib and sunitinib have greatly improved clinical outcomes for patients with gastrointestinal stromal tumors (GIST). Dose optimization of these agents is critical and involves multiple considerations, including ensuring a durable response, monitoring drug blood levels to confirm adequate dosing, deciding whether to use high-dose imatinib or switch to second-line sunitinib in the event of disease progression and appropriately managing treatment-associated side effects. Imatinib is the standard first-line therapy for unresectable or metastatic GIST and is also an option for the adjuvant treatment of resected disease. Despite the efficacy and safety of imatinib in patients with advanced GIST, some individuals develop primary or secondary resistance or intolerance to the drug. For patients with advanced disease, imatinib dose escalation to 800 mg/day is warranted in cases of disease progression on imatinib 400 mg/day. In addition, patients with documented KIT exon 9 mutations are likely to derive benefit from initial treatment with high-dose imatinib to improve clinical outcomes. For patients who fail imatinib, sunitinib is an effective treatment option. However, the decision to use either high-dose imatinib or sunitinib should be based on the underlying cause of failure on imatinib, KIT mutational status and on whether the patient is intolerant of or has developed a resistance to imatinib. In this article we review the existing literature supporting the use of imatinib and sunitinib in GIST to provide a current clinical perspective on how best to use these agents in the management of GIST to optimize patient outcomes.

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Time to secondary resistance (TSR) after interruption of imatinib (IM) in advanced GIST: Updated results of the prospective French Sarcoma Group randomized phase III trial on long-term survival.

Cited by 15 publications

References 0 publications

Improving Adherence to Oral Cancer Therapy in Clinical Practice

Improving Adherence to Oral Cancer Therapy in Clinical Practice

Recent advances in managing gastrointestinal stromal tumor

Dose optimization of tyrosine kinase inhibitors to improve outcomes in GIST

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