title: Advanced gastrointestinal stromal tumor patients with complete response after treatment with imatinib mesylate.
abstract: OBJECTIVE
  Most gastrointestinal stromal tumors (GISTs) express constitutively activated mutant isoforms of kit kinase or platelet-derived growth factor receptor alpha (PDGFRA), which are potential therapeutic targets for imatinib mesylate (Glivec). Partial response occurred in almost two thirds of GIST patients treated with Glivec. However, complete response (CR) after Glivec therapy was sporadically reported. Here we illustrated advanced GIST patients with CR after Glivec treatment.
  
  
  METHODS
  Between January 2001 and June 2005, 42 advanced GIST patients were treated with Glivec. Patients were administered 400 mg of Glivec in 100-mg capsules, taken orally daily with food. The response of the tumor to Glivec was evaluated after one month, three months, and every three months thereafter or whenever medical need was indicated. Each tumor of patients was investigated for mutations of kit or PDGFRA.
  
  
  RESULTS
  The median follow-up time of the 42 advanced GIST patients treated with Glivec was 16.9 months (range, 1.0-47.0 months). Overall, 3 patients had complete response CR (7.1%), 26 partial response (67.8%), 5 stationary disease (11.9%), and 3 progressive disease (11.9%). The median duration of Glivec administration for the three patients was 36 months (range, 23-36 months). The median time to CR after Glivec treatment was 20 months (range, 9-26 months). Deletion and insertion mutations of c-kit exon 11 and insertion mutation of c-kit exon 9 were found in two cases and one case, respectively.
  
  
  CONCLUSIONS
  Complete response (CR) can be achi-eved in selected advanced GIST patients treated with Glivec. The median time to CR after Glivec treatment was 20 months. Deletion and insertion mutations of kit exon 11 and insertion mutation of kit exon 9 contribute to the genetic features in these selected cases.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan, Taiwan, China.
authors.forename: Kun-Chun
authors.initials: KC
authors.lastname: Chiang
authors.forename: Tsung-Wen
authors.initials: TW
authors.lastname: Chen
authors.forename: Chun-Nan
authors.initials: CN
authors.lastname: Yeh
authors.forename: Feng-Yuan
authors.initials: FY
authors.lastname: Liu
authors.forename: Hsiang-Lin
authors.initials: HL
authors.lastname: Lee
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Jan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate