title: Adjuvant imatinib for gastrointestinal stromal tumors: the current situation and problems.
abstract: OBJECTIVE
  To review the current situation and find out the current problems of adjuvant imatinib for gastrointestinal stromal tumors (GISTs).
  
  
  METHODS
  Searching for articles and records about imatinib for GISTs, especially adjuvant imatinib for GISTs, on MEDLINE, EMBASE and international conference on gastrointestinal.
  
  
  RESULTS
  GISTs are derived from mesenchymal cells of the gastrointestinal tract. The standard treatment for primary GISTs is to resect the tumor together with the negative margins completely without tumor rupture and spillage. Conventional chemotherapy and radiotherapy is ineffective for advanced GISTs. The introduction of imatinib has dramatically changed the natural history of advanced GISTs. Imatinib is generally safe and effective with doses of 400, 600 or 800 mg daily, and has become the standard drug in the treatment for patients with advanced GISTs. Furthermore, most of the toxicity of imatinib is minimal and manageable, almost no treatment-related deaths have been reported. Therefore, adjuvant imatinib therapy is safe and seems to improve recurrence-free survival after the resection of primary GISTs.
  
  
  CONCLUSIONS
  Although U.S Food and Drug Administration and European Medicines Agency have approved the use of adjuvant imatinib for GISTs postoperatively, a series of questions about the use of adjuvant imatinib still exist, such as the impact of adjuvant imatinib on overall survival, the optimal dose, the best duration of treatment and the most suitable patients. Doctors and patients should weigh the pros (the decrease of relapse) and cons (drug toxicity and drug costs), especially in terms of the benefit of overall survival.
authors.affiliation: Hepatobiliary Surgery Department of Tumor Hospital, Guangxi Medical University, Nanning, Gaungxi Province, PR China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Zhong
authors.forename: Liang
authors.initials: L
authors.lastname: Ma
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
authors.forename: Hai-Ming
authors.initials: HM
authors.lastname: Ru
authors.forename: Yin-Nong
authors.initials: YN
authors.lastname: Zhao
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate