Imatinib: new indication. Efficacy in gastrointestinal stromal tumours must be confirmed.
(1) Gastrointestinal stromal tumours are rare and have highly variable malignant potential. (2) Available cytotoxic agents have so far failed to reduce tumour burden of inoperable or metastatic gastrointestinal stromal tumours. Only a minority of such patients survive beyond two years. (3) Imatinib, a tyrosine kinase inhibitor, is now approved for use in this indication. (4) A trial lasting nine months and involving 147 patients showed that oral imatinib 400 mg or 600 mg daily led to partial tumour regression in about 50% of cases. The results of ongoing trials should show whether or not this translates into a tangible increase in survival. (5) The main known adverse effects of imatinib are oedema (74% of patients), gastrointestinal, cutaneous and haematological reactions, and muscle pain. One in five patients had adverse effects that the investigators considered severe. (6) Imatinib has the potential to interact with many other drugs. (7) In practice, given the lack of alternatives, patients should be offered imatinib and be enrolled in follow-up cohorts, in order to determine the optimal treatment regimen (especially duration) and the real benefits.
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017277:Drug Approval; D005602:France; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006801:Humans; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D010879:Piperazines; D011743:Pyrimidines; D011505:Protein-Tyrosine Kinases