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Surgery Following Imatinib Treatment Appears to Improve Progression-Free Survival in Patients With GIST: Presented at ASCO

By Bruce Sylvester

ORLANDO, Fla -- June 2, 2009 -- Progression-free survival (PFS) appears to improve in patients with locally advanced gastrointestinal stromal tumours (GIST) that become resectable after imatinib therapy, researchers reported here at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO).

"We sought to assess the outcome of patients with locally advanced primary GIST tumours without metastases treated with [imatinib mesylate] in the neoadjuvant setting within the prospective [French Sarcoma Group] BFR14 phase 3 trial," said investigator Philippe A. Cassier, MD, Hôpital Edouard Herriot, Lyon, France, in a poster presentation on May 31.

The investigators searched the database of the BFR14 trial for subjects with locally advanced disease and no metastases, and they excluded those with recurrent disease. They identified 25 subjects (9 females, 16 males) who met their criteria.

Twenty patients were primary site tumours grade 0 or 1, and the researchers found tumour locations in the small intestine (n = 7), peritoneum (n = 7), rectum (n = 4), stomach (n = 4), oesophagus (n = 2), and pelvis (n = 1).

They also reported that 9 of the 25 subjects had undergone surgical resection of the primary tumour after a median of 7.3 months (range 3.4-12.1 months) of treatment with imatinib.

The investigators identified a significant improvement in PFS among the subjects who underwent surgical resection versus those who did not, with median PFS of 28.7 versus 12.9 months (P = .0463).

PFS did not translate into a statistically significant benefit in overall survival. However, the statistical trend was in favour of the resected group (P = .0677).

"Surgery may increase progression-free survival in patients with locally advanced GIST who become resectable following treatment with imatinib," the authors concluded.

[Presentation title: Neoadjuvant Imatinib in Patients With Locally Advanced GIST in the
Prospective BFR14 Trial. Abstract 10551]

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