Treatment with Gleevec® (imatinib) for 3 years following surgery significantly improves survival compared with the standard one-year therapy for patients with gastrointestinal stromal tumors (GIST).
GIST is a type of soft tissue sarcoma that develops in the stomach, small intestine, or other parts of the gastrointestinal tract. Treatment of early GIST often involves surgery followed by treatment with Gleevec. Gleevec is a type of targeted therapy that inhibits a specific protein that is overactive in the majority of GIST cells.
Researchers from Scandinavia recently conducted a clinical study (The Scandinavian Sarcoma Group XVIII/AIO trial) to explore the effectiveness of longer therapy with Gleevec among patients with GIST. The study included 400 patients with early GIST who were at a high risk of experiencing a recurrence. Following surgery, one group was treated with Gleevec for 3 years while the other group was treated with Gleevec for one year.
- Survival was significantly improved for the group of patients treated with Gleevec for 3 years compared to those treated for only one year. At 5 years, survival was 92% for the 3-year group and 81.7% for the 1-year group.
- Survival with no evidence of cancer recurrences (recurrence-free survival) was also improved in the group of patients treated with Gleevec for 3 years. Three years following surgery, recurrence-free survival was 65.5% in the 3-year group compared with 48% in the 1-year group.
- By the end of therapy with Gleevec, 14% of the group treated for 3 years and 8% of the group treated for one year had discontinued therapy due to side effects.
The lead author of the study stated that although one year of postoperative Gleevec is currently the standard of care for early GIST, “these results are very compelling.” Furthermore, the author stated that the optimal duration of therapy with Gleevec is not yet known, as trials evaluating longer treatment times have not yet been conducted.
Reference: Joensuu H, Eriksson M, Hatrmann J, et al. Twelve versus 36 months of adjuvant imatinib (IM) as treatment of operable GIST with a high risk of recurrence: Final results of a randomized trial (SSGXVIII/AIO). Paper presented at: 2011 Annual Meeting of the American Society of Clinical Oncology; June 3-7, 2011; Chicago, IL. Abstract LBA1.