Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib

Purpose. This retrospective, nonrandomized study investigated the effect of imatinib rechallenge plus best supportive care (BSC) on overall survival after imatinib and sunitinib treatment for patients with locally advanced or metastatic gastrointestinal stromal tumor (GIST). Methods. Twenty-six pati...

Full description

Saved in:
Bibliographic Details
Main Authors: Akira Sawaki, Tatsuo Kanda, Yoshito Komatsu, Toshirou Nishida
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2014/342986
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850166916270784512
author Akira Sawaki
Tatsuo Kanda
Yoshito Komatsu
Toshirou Nishida
author_facet Akira Sawaki
Tatsuo Kanda
Yoshito Komatsu
Toshirou Nishida
author_sort Akira Sawaki
collection DOAJ
description Purpose. This retrospective, nonrandomized study investigated the effect of imatinib rechallenge plus best supportive care (BSC) on overall survival after imatinib and sunitinib treatment for patients with locally advanced or metastatic gastrointestinal stromal tumor (GIST). Methods. Twenty-six patients who had previously been exposed to both imatinib and sunitinib were enrolled in this study. The treatment regimen was BSC with or without imatinib, based on the patient’s choice after discussion with his or her physician. The primary endpoint was overall survival, and secondary endpoints were time to treatment failure, clinical response rate assessed by Choi criteria, and safety. Results. Fourteen patients were treated with imatinib plus BSC and 12 received BSC alone. Median overall survival was greatly improved for the imatinib group, although differences were not significant (22 months for imatinib plus BSC versus 4 months for BSC; P=0.058). Three patients (21%) had a clinical response in the imatinib group, and one had a clinical response in the BSC alone group. Imatinib was well tolerated. Conclusions. Rechallenge with imatinib may be associated with improvement in overall survival without deteriorating performance status in patients who failed imatinib and sunitinib. A prospective study should be considered to confirm the efficacy of rechallenge with imatinib.
format Article
id doaj-art-e54e5dff5cc24ebea4bc1cbfdbcbc712
institution OA Journals
issn 1687-6121
1687-630X
language English
publishDate 2014-01-01
publisher Wiley
record_format Article
series Gastroenterology Research and Practice
spelling doaj-art-e54e5dff5cc24ebea4bc1cbfdbcbc7122025-08-20T02:21:19ZengWileyGastroenterology Research and Practice1687-61211687-630X2014-01-01201410.1155/2014/342986342986Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and SunitinibAkira Sawaki0Tatsuo Kanda1Yoshito Komatsu2Toshirou Nishida3Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya-shi, Aichi 464-8681, JapanDigestive and General Surgery 2 Division, Niigata University Hospital, 754 Ichibancho, Asahimachidori, Chuo-ku, Niigata-shi, Niigata 951-8510, JapanDepartment of Cancer Chemotherapy, Hokkaido University Hospital, Cancer Center, Kita 14-jo Nishi 5-chome, Kita-ku, Sapporo-shi, Hokkaido 060-8648, JapanDepartment of Surgery, Osaka University, School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, JapanPurpose. This retrospective, nonrandomized study investigated the effect of imatinib rechallenge plus best supportive care (BSC) on overall survival after imatinib and sunitinib treatment for patients with locally advanced or metastatic gastrointestinal stromal tumor (GIST). Methods. Twenty-six patients who had previously been exposed to both imatinib and sunitinib were enrolled in this study. The treatment regimen was BSC with or without imatinib, based on the patient’s choice after discussion with his or her physician. The primary endpoint was overall survival, and secondary endpoints were time to treatment failure, clinical response rate assessed by Choi criteria, and safety. Results. Fourteen patients were treated with imatinib plus BSC and 12 received BSC alone. Median overall survival was greatly improved for the imatinib group, although differences were not significant (22 months for imatinib plus BSC versus 4 months for BSC; P=0.058). Three patients (21%) had a clinical response in the imatinib group, and one had a clinical response in the BSC alone group. Imatinib was well tolerated. Conclusions. Rechallenge with imatinib may be associated with improvement in overall survival without deteriorating performance status in patients who failed imatinib and sunitinib. A prospective study should be considered to confirm the efficacy of rechallenge with imatinib.http://dx.doi.org/10.1155/2014/342986
spellingShingle Akira Sawaki
Tatsuo Kanda
Yoshito Komatsu
Toshirou Nishida
Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib
Gastroenterology Research and Practice
title Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib
title_full Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib
title_fullStr Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib
title_full_unstemmed Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib
title_short Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib
title_sort impact of rechallenge with imatinib in patients with advanced gastrointestinal stromal tumor after failure of imatinib and sunitinib
url http://dx.doi.org/10.1155/2014/342986
work_keys_str_mv AT akirasawaki impactofrechallengewithimatinibinpatientswithadvancedgastrointestinalstromaltumorafterfailureofimatinibandsunitinib
AT tatsuokanda impactofrechallengewithimatinibinpatientswithadvancedgastrointestinalstromaltumorafterfailureofimatinibandsunitinib
AT yoshitokomatsu impactofrechallengewithimatinibinpatientswithadvancedgastrointestinalstromaltumorafterfailureofimatinibandsunitinib
AT toshirounishida impactofrechallengewithimatinibinpatientswithadvancedgastrointestinalstromaltumorafterfailureofimatinibandsunitinib