title: Influence of imatinib interruption and rechallenge on the residual disease in patients with advanced GIST: results of the BFR14 prospective French Sarcoma Group randomised, phase III trial.
abstract: BACKGROUND
  We previously demonstrated that interruption of imatinib mesylate (IM) in responding patients (pts) with advanced gastrointestinal stromal tumours (GISTs) results in rapid reprogression. The impact of interruption on residual tumour, quality of response and secondary resistance has not been fully investigated.
  
  
  METHODS
  Within the BRF14 study, 71 non-progressing patients were randomly assigned in the interruption arms after 1, 3 or 5 years. IM was resumed in the case of progressive disease (PD). Tumour status at randomisation, relapse and after IM rechallenge, progression-free survival (PFS) and time to secondary resistance were analysed.
  
  
  RESULTS
  At data cut-off, 51 of 71 patients had restarted IM following documented PD. Eighteen patients (35%) progressed on known lesions only, while 33 patients (65%) had new lesions, with concomitant progression of known lesions in 17 patients. Only 8 (42%) of complete remission (CR) patients and 12 (52%) of partial response (PR) patients at randomisation achieved a new CR and PR. Patients progressing rapidly after interruption had a poorer prognosis. Tumour status at randomisation influenced time to progression after rechallenge.
  
  
  CONCLUSIONS
  In advanced GIST patients interrupting IM, quality of response upon reintroduction did not reach the tumour status observed at randomisation. Rapid progression after imatinib interruption is associated with poor PFS after reintroduction.
authors.affiliation: Department of Medicine, Institut Gustave Roussy, Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Patrikidou
authors.forename: S
authors.initials: S
authors.lastname: Chabaud
authors.forename: I
authors.initials: I
authors.lastname: Ray-Coquard
authors.forename: B N
authors.initials: BN
authors.lastname: Bui
authors.forename: A
authors.initials: A
authors.lastname: Adenis
authors.forename: M
authors.initials: M
authors.lastname: Rios
authors.forename: F
authors.initials: F
authors.lastname: Bertucci
authors.forename: F
authors.initials: F
authors.lastname: Duffaud
authors.forename: C
authors.initials: C
authors.lastname: Chevreau
authors.forename: D
authors.initials: D
authors.lastname: Cupissol
authors.forename: J
authors.initials: J
authors.lastname: Domont
authors.forename: D
authors.initials: D
authors.lastname: Pérol
authors.forename: J Y
authors.initials: JY
authors.lastname: Blay
authors.forename: A
authors.initials: A
authors.lastname: Le Cesne
mesh_terms: D000328:Adult; D000368:Aged; D001549:Benzamides / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects; D012509:Sarcoma / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate