Glivec
THERAPY & HOPE
Imatinib mesylate
IMATINIB MESYLATE (Glivec) in Gastrointestinal stromal tumor (GIST)
BACKGROUND: Gastrointestinal stromal tumor (GIST) is a rare gastrointestinal tumor. It is known to be resistant to radio – and chemo – therapy. The administration of imatinib mesylate, a tyrosine kinase inhibitor, resulted in a dramatic response and improved survival in patients with GIST. In this study we examined the long term response and side effects of imatinib treatment in Istaely patients with GIST. PATIENTS AND METHODS: We followed 25 patients from various hospitals in Israel treated between 2001 and 2006. The mean follow up time was 36.3 months (17-63 mo.). RESULTS: One patient achieved complete response, 13 patients (52%) achieved partial response, 9 patients (35%) achieved stable disease, and 2 patients did not have measurable disease. The median survival was not yet reached. Twelve patients (48%) had a decrease in the attenuation of the tumor into a cystic appearance. Eleven patients (44%) developed late resistance to the treatment (after 7-54 months). The median time to progression was not yet reached. The adverse events were mostly mild. Severe adverse events (grade 3-4 CTC criteria) occurred in 24% of the patients. There was no advantage regarding survival or time to progression for the patients who had partial response compared to those patients who had stable disease (P=0.39 and P=0.71 respectively). CONCLUSIONS: Imatinib results in a dramatic response in patients with GIST, and is well tolerated. The introduction of new drugs such as sunitinib which is now in advanced phase of clinical study, may give additional solution in the treatment of GIST .
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