Length of adjuvant imatinib therapy in GIST: weighing benefits, side effects and costs.
A recent large randomized clinical trial showed a survival advantage with 36 vs 12 months of adjuvant imatinib in patients with resected gastrointestinal stromal tumors (GISTs). However, there was a higher therapy discontinuation rate with the longer duration of treatment. Preferences of individual GIST patients and the imatinib risk/benefit ratio should always be sought before employing this agent in adjuvant setting for longer than 12 months. A shorter duration of therapy may be preferred in patients with a limited life expectancy, serious cardiovascular co-morbidities, diminished compliance or poor adherence to oral therapy. Further study of underlying economic, psychosocial, and physical barriers of longer vs shorter duration of adjuvant therapy in this patient population is probably warranted.
Department of Hematology-Oncology, St. Francis Hospital and Medical Center, Hartford, CT 06105, USA. c_dasanu@yahoo.com
Constantin A
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Dasanu
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D001549:Benzamides; D017024:Chemotherapy, Adjuvant / Q000379:methods; D004334:Drug Administration Schedule; D016527:Drug Costs; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D055118:Medication Adherence; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate