Efficacy and safety evaluation of two doses of imatinib for the treatment of advanced gastrointestinal stromal tumors (GISTs).
OBJECTIVE
Imatinib is approved worldwide for use in gastrointestinal stromal tumours (GISTs). To evaluate the efficacy and safety of two dose of imatinib treatment for patients with GISTs, a meta-analysis was performed.


METHODS
Electronic search of the PubMed and EMBASE, which have articles published between 1980 and February 2012, was conducted to select studies for this meta-analysis.


RESULTS
Five articles with a total number 1861 of advanced GISTs patients were involved in this meta-analysis. There was a slight but significant 2-year PFS advantage with high-dose group (OR=1.25, 95% CIs=1.03-1.52, P=0.03), but not in the 2-year OS (OR=1.02, 95% CIs=0.84-1.24, P=0.87), CR (OR=1.02, 95% CIs=0.66-1.58, P=0.93), and PR (OR=1.13, 95% CIs=0.94-1.36, P=0.20). In safety, the high-dose group increased the incidence of above grade 3 toxicity (OR=2.05, 95% CIs=1.70-2.48, P<0.00001), particular in the blood toxicity, skin disorders, nausea and so on.


CONCLUSIONS
This analysis confirms a slight 2-year PFS advantage of high-dose imatinib, but imatinib dose escalation could not lead to any other major clinical benefits, and brought more toxic effects for patients.
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu 610041, Sichuan Province, China.
Ping
P
Yang
Bo
B
Chen
Yong
Y
Zhou
Xiao-Ting
XT
Wu
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001549:Benzamides / Q000008:administration & dosage* / Q000009:adverse effects; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D009367:Neoplasm Staging; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate