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Posted on 21 Янв 201819

Long-Term Imatinib Prevents Recurrence in GIST - OncLive

Long-Term Imatinib Prevents Recurrence in GIST - OncLive
Jul 19, 2017 ... Patients with intermediate- or high-risk gastrointestinal stromal tumors (GIST) were less likely to experience recurrence after 5 years of treatment with imatinib ( Gleevec), as determined by results from the phase II PERSIST-5 trial. “Chronic imatinib was effective in preventing recurrences during treatment for ...

Raut said that patient had a high-risk, gastric GIST with a “The only patient who recurred on-drug had an insensitive mutation,” he said. Treatment continued for 5 years or until progression, relapse, or intolerance. Join us for a LIVE webinar with Drs. Twenty-one percent of patients discontinued by choice and 16% discontinued because of adverse events (AEs). Recent data from the American College of Surgeons Oncology Group (ACOSOG) has demonstrated that mutation status is not an independent predictor of recurrence in patients treated with adjuvant imatinib, however patients with Microscopic positive margins have not yet been shown to influence recurrence in patients treated with adjuvant imatinib.

GISTs are an aggressive tumor that have historically portended a poor prognosis. In 1998, a groundbreaking discovery was made that GISTs arise due to oncogenic mutations in the KIT tyrosine kinase, and subsequently it was found that mutations in platelet derived growth factor receptor α ( Over the past 15 years, much progress has been made in uncovering the kinase driven biology of GIST and targeting the mutant oncoproteins. Diagnosis of gastrointestinal stromal tumors: A consensus approach. A similar mutational analysis of SWOG S0033 showed improved response rates with 400 mg twice daily imatinib in exon 9 mutant tumors (67% vs. Use of positron emission tomography in oncology and its potential role to assess response to imatinib mesylate therapy in gastrointestinal stromal tumors (GISTs) Choi H.

It is currently unknown if imatinib is effective compared to chemotherapy in different mutant subtypes, however all mutant subtypes treated with imatinib appear to have improved PFS, and OS compared to unstratified historical controls treated with chemotherapy. Clinical Vignette Series: 34th Annual Chemotherapy Foundation Symposium: Innovative Cancer Therapy for Tomorrow® Medical Crossfire®: Bridging Emerging Data to Advance Treatment Planning for Hepatocellular Carcinoma: A Multidisciplinary Tumor Board Covering Every Angle of Oncology Practice. Prospective multicentric randomized phase III study of imatinib in patients with advanced gastrointestinal stromal tumors comparing interruption versus continuation of treatment beyond 1 year: the French Sarcoma Group. Dei Tos recently reported a nomogram predicting 10-year RFS using mitotic index and size as continuous variables. Whether prolonged therapy is only effective in exon 11 deletions, and the specific benefit in different recurrence risk subgroups stratified by mutational status also remains unknown. Natural History of Imatinib-naive GISTs: A Retrospective Analysis of 929 Cases With Long-term Follow-up and Development of a Survival Nomogram Based on Mitotic Index and Size as Continuous Variables. There were 3 deaths in the study, including the patient who recurred while on treatment. Imatinib mesylate (STI-571 Glivec, Gleevec) is an active agent for gastrointestinal stromal tumours, but does not yield responses in other soft-tissue sarcomas that are unselected for a molecular target. Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas.

GIST tumors: Who should get imatinib and for how long? - NCBI - NIH
Jul 29, 2014 ... Structural similarities between the BCR-ABL and KIT kinases prompted administration of imatinib to a patient with advanced GIST that resulted in a dramatic response. This initial breakthrough triggered a wave of clinical trials examining imatinib in GIST, starting with trials in metastatic disease followed by ...

GLIVEC® (imatinib) is indicated for the treatment of unresectable and/or metastatic and adjuvant KIT+ GIST.

He presented the findings at the 2017 ASCO Annual Meeting. Thus, early results suggest that salvage imatinib is effective and is appropriate in patients with recurrent disease. Discontinuation of imatinib in patients with advanced gastrointestinal stromal tumours after 3 years of treatment: an open-label multicentre randomised phase 3 trial. Based on the sum of the points generated, ). Overall survival for study population of EORTC 62005 compared with historical controls from EORTC database.

NCCN guidelines recommend neoadjuvant imatinib in patients who have primary, unresectable tumors or resectable tumors with a risk of significant morbidity, to reduce the tumor size before surgery and minimize morbidity. R0/R1 resection, or mitotic index (>10 mitoses/50 HPF or ≤ 10 mitoses/50 HPF). Development and validation of a prognostic nomogram for recurrence-free survival after … Rossi S, et al. Two phase II trials have demonstrated the safety and efficacy of neoadjuvant imatinib to allow for tumor shrinkage and a subsequent R0 resection with primary GIST that appears borderline or unresectable. Contour maps to predict risk of recurrence have also been developed, that are marginally more accurate than the above mentioned schema.

Of those events, 7 were considered “true” recurrences, and 6 occurred after discontinuation. Response to imatinib rechallenge of GIST that recurs following completion of adjuvant imatinib treatment - the first analysis in the SSGXVIII/AIO trial patient population. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. Imatinib failure-free survival (IFS) in patients with localized gastrointestinal stromal tumors (GIST) treated with adjuvant imatinib (IM): The EORTC/AGITG/FSG/GEIS/ISG randomized controlled phase III trial. An initial dose of 400 mg daily is indicated, however patients with exon 9 mutations may benefit from dose escalation. Surgery of residual disease following molecular-targeted therapy with imatinib mesylate in advanced/metastatic GIST. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Phase III randomized, intergroup trial assessing imatinib mesylate at two dose levels in patients with unresectable or metastatic gastrointestinal stromal tumors expressing the kit receptor tyrosine kinase: S0033. Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST) Fletcher CDM, et al.

GLIVEC Imatinib Gleevec 400 mg -

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