Abstract
BackgroundAbout 80% of patients with GIST would experience tumor recurrence or metastasis after radical resection. The most common site of the metastasis is the liver. Imatinib mesylate has been proved effective for advanced GIST. The present study was designed to further observe the effectiveness of the imatinib mesylate treatment on the recurrent GIST and the correlation between the liver metastasis and the outcome.MethodsForty-two patients who had recurrent GIST after the first radical resection were enrolled. According to the recurrent sites, the patients were divided into 3 groups: group LG (recurrent liver GISTs), group AG (recurrent abdominal GISTs) and group ALG (recurrent abdominal and liver GISTs). All the patients were given imatinib mesylate at an initial dose of 400 mg per day. Their clinical data was prospectively collected. A follow-up over 3 years was conducted. Tumor response, time to progression and survival were evaluated.ResultsThe long-term Imatinib mesylate treatment was safe and well tolerated. At a median follow-up time for 39.5 months, the 3-year survival rate was 66.7%. Median TTP and OS were 37 months (95% CI: 28.2~45.8 months) and 48 months (95% CI: 37.0~58.9 months), respectively. There was no statistical difference in tumor response among the 3 groups. The similar TTP (P = 0.291) and OS (P = 0.160) were observed in the 3 groups.ConclusionsThe imatinib mesylate treatment could prolong the survival of the patients who have recurrent GIST after the radical surgery in spite of an existence of the liver metastasis. Survival was not significantly affected by liver metastasis when imatinib mesylate was warranted.
Highlights
About 80% of patients with Gastrointestinal stromal tumor (GIST) would experience tumor recurrence or metastasis after radical resection
GIST expresses mutant protein-tyrosine kinase KIT (CD117), which results in constitutive activation of the KIT receptor tyrosine kinase [3,4]
The treatment exposure and the follow-up The 42 patients with recurrent or/and metastatic GIST after the first radical resection were treated with imatinib mesylate at an initial dose of 400 mg per day. 11 of the patients increased the dose level to 600 mg per day due to the tumor progression, 3 of the patients changed to use sunitinib because of the failure of imatinib mesylate treatment
Summary
About 80% of patients with GIST would experience tumor recurrence or metastasis after radical resection. Imatinib mesylate has been proved effective for advanced GIST. The present study was designed to further observe the effectiveness of the imatinib mesylate treatment on the recurrent GIST and the correlation between the liver metastasis and the outcome. About 80% of the patients have the tumor recurrence or/and metastasis after the radical operation, Imatinib mesylate, a small-molecule orally bioavailable drug, is able to inhibit KIT. Imatinib mesylate has proved to be the most active agent for advanced GIST [10,11]. A long-term follow-up phase II study on the imatinib mesylate treatment for the patients with advanced GIST has BioMed Central tribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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