Pattern of progression and its impact on outcome in patients with gastrointestinal stromal tumors after initial response to imatinib mesylate: A retrospective multicenter long-term follow-up study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9541-9541
Author(s):  
J. T. Hartmann ◽  
F. Heidel ◽  
J. Stoehlmacher ◽  
M. Duex ◽  
J. R. Izbicki ◽  
...  
Keyword(s):  
Disease Progression ◽  
Gastrointestinal Stromal Tumors ◽  
Local Treatment ◽  
Progression Free Survival ◽  
Initial Response ◽  
Imatinib Resistance ◽  
Kit Mutation ◽  
Stromal Tumors ◽  
Long Term Follow Up

9541 Background: To investigate the clinical impact of the different types of disease progression (focal v extensive) in patients (pts) with metastatic gastrointestinal stromal tumors (GIST) after initial response to imatinib. Methods: Pts who received imatinib for metastatic GIST at three Cancer Centers and who have been followed up for at least 2.5 years were eligible for the study. Disease progression was classified as focal or extensive as defined by protocol. Responses were evaluated according to WHO criteria. Progression-free survival (PFS) and overall survival (OS) were calculated according to the Kaplan-Meier-method. In three pts with focal progressions, serial biopsies were obtained for mutation analysis. Results: Thirty-eight patients (21 men; mean age 58.4 years; range, 37–73 years) were included in the analysis. After a median follow-up of 31.8 mos, 25 of 38 (65.8%) patients had progressed. Nine of 25 progressions were classified as focal and 16 as extensive. Salvage therapies included dose escalation of imatinib with or without surgical resection. Median and 6- and 12-mos PFS were 11.3 mos, 89%, and 40% in pts with focal progression, and 2.5 mos, 39%, and 32%, in patients with extensive progression, respectively. The median OS was 22.8 mos in pts with extensive progression, and was not reached in pts with focal progression. Two subsequent focal progressions in one pt were associated with 2 different secondary KIT-mutations, whereas non-progressive disease harbored the original KIT-mutation alone. Conclusions: Imatinib resistance seems to be partial in a subset of progressing GIST pts. These pts may benefit from local treatment and imatinib continuation and further investigation of imatinib combinations with other compounds appears warranted. Extensive progression is associated with a dismal survival. No significant financial relationships to disclose.

W1723 Long-Term Follow-up of Patients With Gastric Gastrointestinal Stromal Tumors (GISTs) 5 CM or Less After Surgical or Endoscopic Resection

2010 ◽  
Vol 138 (5) ◽  
pp. S-727
Author(s):  
Mi-Young Kim ◽  
Kee Don Choi ◽  
Jeong Hoon Lee ◽  
Hye-won Park ◽  
Do Hoon Kim ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Gastrointestinal Stromal Tumors ◽  
Stromal Tumors ◽  
Long Term Follow Up

Imatinib mesylate therapy in advanced gastrointestinal stromal tumors—A Regional cancer centre experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 19505-19505
Author(s):  
K. M. Patel ◽  
P. M. Shah ◽  
S. N. Shukla ◽  
B. J. Parikh ◽  
A. S. Anand ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Imatinib Mesylate ◽  
Metastatic Disease ◽  
Gastrointestinal Stromal Tumors ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Free Survival ◽  
Stromal Tumors ◽  
Post Surgery

19505 Background: The treatment of gastrointestinal stromal tumors has been revolutionised by the advent of Imatinib, a specific tyrosine kinase inhibitor. Post operative local and metastatic recurrences of this tumor have been effectively managed by Imatinib. Here we present our experience of Imatinib in recurrent locally advanced/metastatic gastrointestinal stromal tumors (GIST). Methods: From Nov 2001 to Sep 2005, 33 patients with metastatic and / or locally advanced inoperable CD-117 positive GIST were offered imatinib mesylate therapy at 400 mg/day p.o. A total of 21 patients were evaluable for tumor response. Follow up period ranged from 4 months to 38 months with median follow up period being 18 months. Median age is 58 yrs, M:F ratio is 6:4. ECOG performance status was 0–1 in 70% (23 patients) and 2 in 30% (10 patients). 70% patients had post surgery recurrence. 2 patients (6%) had received adjuvant chemotherapy prior to recurrence. 30% (10 patients) had local recurrence, 40% (13 patients) had metastatic disease while 30% (10 patients) had local recurrence as well as metastatic disease. Results: Response evaluation was done by RECIST criteria. 15% (5 patient) showed CR while PR rates were 30% (10 patients). The overall major response (CR+PR) was 45%. The overall progression free survival was as high as 80%. All the patients who had a progression free survival also had a significant improvement in quality of life. Conclusions: Imatinib mesylate therapy shows significant survival benefits in locally advanced inoperable/metatstatic gastrointestinal stromal tumors. It will be a very long time before PET scan for evaluation and follow up becomes feasible in developing country setting. No significant financial relationships to disclose.

Ten-Year Progression-Free and Overall Survival in Patients With Unresectable or Metastatic GI Stromal Tumors: Long-Term Analysis of the European Organisation for Research and Treatment of Cancer, Italian Sarcoma Group, and Australasian Gastrointestinal Trials Group Intergroup Phase III Randomized Trial on Imatinib at Two Dose Levels

2017 ◽  
Vol 35 (15) ◽  
pp. 1713-1720 ◽  
Author(s):  
Paolo G. Casali ◽  
John Zalcberg ◽  
Axel Le Cesne ◽  
Peter Reichardt ◽  
Jean-Yves Blay ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Performance Status ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Kit Mutation ◽  
Free Survival ◽  
Stromal Tumors

Purpose To report on the long-term results of a randomized trial comparing a standard dose (400 mg/d) versus a higher dose (800 mg/d) of imatinib in patients with metastatic or locally advanced GI stromal tumors (GISTs). Patients and Methods Eligible patients with advanced CD117-positive GIST from 56 institutions in 13 countries were randomly assigned to receive either imatinib 400 mg or 800 mg daily. Patients on the 400-mg arm were allowed to cross over to 800 mg upon progression. Results Between February 2001 and February 2002, 946 patients were accrued. Median age was 60 years (range, 18 to 91 years). Median follow-up time was 10.9 years. Median progression-free survival times were 1.7 and 2.0 years in the 400- and 800-mg arms, respectively (hazard ratio, 0.91; P = .18), and median overall survival time was 3.9 years in both treatment arms. The estimated 10-year progression-free survival rates were 9.5% and 9.2% for the 400- and 800-mg arms, respectively, and the estimated 10-year overall survival rates were 19.4% and 21.5%, respectively. At multivariable analysis, age (< 60 years), performance status (0 v ≥ 1), size of the largest lesion (smaller), and KIT mutation (exon 11) were significant prognostic factors for the probability of surviving beyond 10 years. Conclusion This trial was carried out on a worldwide intergroup basis, at the beginning of the learning curve of the use of imatinib, in a large population of patients with advanced GIST. With a long follow-up, 6% of patients are long-term progression free and 13% are survivors. Among clinical prognostic factors, only performance status, KIT mutation, and size of largest lesion predicted long-term outcome, likely pointing to a lower burden of disease. Genomic and/or immune profiling could help understand long-term survivorship. Addressing secondary resistance remains a therapeutic challenge.

28 P Gastrointestinal stromal tumors: Long term follow up by EUS up to 13 years

2002 ◽  
Vol 34 ◽  
pp. A116
Author(s):  
P. Fusaroli ◽  
E. Khodadadian ◽  
R.N.A.L.D. Vallar ◽  
T. Togliani ◽  
N. Salfi ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Stromal Tumors ◽  
Long Term Follow Up

scholarly journals Clinicopathologic Characteristics and Treatment Outcomes of Rectal Gastrointestinal Stromal Tumors: A Retrospective Study

2021 ◽  
pp. 1-5
Author(s):  
Chujun Li ◽  
Yi Lu ◽  
Junrong Chen ◽  
Honglei Chen ◽  
Jiachen Sun ◽  
...  
Keyword(s):  
Medical Records ◽  
Gastrointestinal Stromal Tumors ◽  
Anal Verge ◽  
Clinicopathologic Characteristics ◽  
Stromal Tumors ◽  
History Information ◽  
Long Term Follow Up ◽  
Rectal Gists

Background and Study Aims: To investigate the clinicopathologic characteristics, surgical and imatinib management and long-term follow-up outcomes of the rectal gastrointestinal stromal tumors (GISTs). Patients and Methods: Consecutive patients with rectal GISTs admitted to our center (from January 2013 to June 2018) were chosen. Their history information was viewed, and the follow-up results were obtained by phone or medical records. Results: Forty-nine patients (32 males and 17 females) were identified, with a median age of 59 years, and 36 patients received surgery. Most (46 patients, 93.9%) of the tumor were located within 6 cm from the anal verge, 18 patients (36.7%) had very low or low risk, and 31 patients (63.3%) had intermediate or high risk. Four kinds of surgery approach were applied in our center: trans-abdominal (8 patients, 22.2%), trans-anal/trans-perineal (15 patients, 41.7%), trans-sacral (12 patients, 33.3%) and abdominoperineal (1 patient, 2.8%). The complication is low and the mortality related to surgery is 0%. After a median follow-up of 705 days (ranged from 48 days to 1677 days), 3 patients (8.33%) were found to have a recurrence. Conclusion: Trans-anal/trans-perineal and trans-sacral surgery were more commonly used in our study, and for now, the recurrence rate had no difference, but a longer time for follow-up is needed.

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