title: Managing GIST in the imatinib era: optimization of adjuvant therapy.
abstract: We reviewed studies evaluating the clinical benefits of 1 year or more of adjuvant imatinib therapy in patients with gastrointestinal stromal tumor (GIST). Data from the Scandinavian Sarcoma Group (SSG) XVIII/AIO Phase III trial of 1 year versus 3 years of adjuvant imatinib support the use of 3 years as standard of care in patients who are at high risk for GIST recurrence following resection. Although adjuvant imatinib therapy prolonged recurrence-free survival in the evaluated trials, overall survival was not significantly increased except in the SSG XVIII/AIO trial. The optimal duration of therapy, and whether high-risk patients should use adjuvant imatinib continuously, remains unknown. The importance of risk assessment, risk stratification and GIST genotype in patient selection is also discussed.
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Avenue, Suite 3513, Miami, FL 33136, USA.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Trent
authors.forename: Meenakshi P
authors.initials: MP
authors.lastname: Subramanian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate
keywords: GIST; adjuvant drug therapy; gastrointestinal stromal tumor; imatinib mesylate; mutational analysis