Prospective evaluation of neoadjuvant imatinib use in locally advanced gastrointestinal stromal tumors: Emphasis on the optimal duration of neoadjuvant imatinib use, safety, and oncological outcome

Shang Yu Wang, Chiao En Wu, Chun Chi Lai, Jen Shi Chen, Chun Yi Tsai, Chi Tung Cheng, Ta Sen Yeh, Chun Nan Yeh

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Background: Neoadjuvant imatinib therapy has been proposed for routine practice with favorable long-term results for patients with locally advanced gastrointestinal stromal tumors (GISTs). However, clarification of the optimal duration, safety, and oncological outcomes of neoadjuvant imatinib use before surgical intervention remains necessary. Methods: We prospectively analyzed the treatment outcomes of 51 patients with locally advanced, nonmetastatic GISTs treated with neoadjuvant imatinib followed by surgery. The optimal duration was defined as the timepoint when there was a <10% change in the treatment response or a size decrease of less than 5 mm between two consecutive computed tomography scans. Results: Primary tumors were located in the stomach (23/51; 45%), followed by the rectum (17/51; 33%), ileum/jejunum (9/51; 18%), and esophagus (2/51; 4%). The median maximal shrinkage time was 6.1 months, beyond which further treatment may not be beneficial. However, the maximal shrinkage time was 4.3 months for the stomach, 8.6 months for the small bowel and 6.9 months for the rectum. The R0 tumor resection rate in 27 patients after neoadjuvant imatinib and surgery was 81.5%, and 70.4% of resection procedures succeeded in organ preservation. However, 10 of 51 patients (19.6%) had complications following neoadjuvant imatinib use (six from imatinib and four from surgery). Conclusion: Our analysis supports treating GIST patients with neoadjuvant imatinib, which demonstrated favorable long-term results of combined therapy. However, careful monitoring of complications is necessary. The optimal duration of neoadjuvant imatinib use before surgical intervention is, on average, 6.1 months.

Original languageEnglish
Article number424
JournalCancers
Volume11
Issue number3
DOIs
Publication statusPublished - Mar 2019
Externally publishedYes

Keywords

  • Gastrointestinal stromal tumors
  • GIST
  • Imatinib
  • Neoadjuvant therapy
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Prospective evaluation of neoadjuvant imatinib use in locally advanced gastrointestinal stromal tumors: Emphasis on the optimal duration of neoadjuvant imatinib use, safety, and oncological outcome'. Together they form a unique fingerprint.

Cite this