Comparison of prognosis between neoadjuvant imatinib and upfront surgery for GIST: A systematic review and meta-analysis

Liu, Zhen; Zhang, Zimu; Sun, Juan; Li, Jie; Zeng, Ziyang; Ma, Ming; Ye, Xin; Feng, Fan; Kang, Weiming

doi:10.3389/fphar.2022.966486

Cited by 6 publications

(4 citation statements)

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“…A systematic review conducted in August 2022 encompassing patients with rectal GISTs located throughout the gastrointestinal tract indicated that individuals who received imatinib therapy before surgical resection had improved overall survival rates compared with those who underwent surgical resection without prior chemotherapy. Nevertheless, the survival rates without disease were similar in both groups 19 …”

Section: Discussionmentioning

confidence: 78%

“…Nevertheless, the survival rates without disease were similar in both groups. 19 In our case, after a multidisciplinary discussion with radiology specialists, we determined that excision of the mass with an intact capsule was feasible following a transanal wide excision. Due to the significantly elevated mitotic index, imatinib 400 mg/day was prescribed.…”

Section: F I G U R Ementioning

confidence: 90%

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Adjuvant therapy for rare rectal gastrointestinal stromal tumors: A case report

Chu,

Pu,

Chen

2024

Clinical Case Reports

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Key Clinical MessageAnorectal gastrointestinal stromal tumors are extremely rare, constituting less than 0.1% of rectal tumors. Surgical resection using a transanal wide excision followed by adjuvant therapy with tyrosine kinase inhibitors can be a successful treatment combination to remove the mass and prevent recurrence while preserving the integrity of the anal sphincter.AbstractGastrointestinal stromal tumors (GISTs) are a rare subset of neoplasms, accounting for about 1%–2% of primary gastrointestinal malignancies. The stomach is the most common site for GISTs, with anorectal GISTs being exceptionally rare, representing only 0.1% of all rectal tumors. The standard approach for managing localized GIST involves complete surgical excision to achieve negative microscopic margins (R0) while preserving the tumor capsule and maintaining anal sphincter function. Surgical resection with transanal wide excision followed by adjuvant therapy using tyrosine kinase inhibitors can successfully remove the mass, prevent recurrence, and preserve the anal sphincter's integrity. Adjuvant therapy with imatinib is the recommended treatment for all localized GISTs assessed to have an intermediate or high risk of relapse. Here, we report a case of a 63‐year‐old male with a rectal GIST who underwent transanal wide excision followed by adjuvant therapy with tyrosine kinase inhibitors.

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Section: Discussionmentioning

confidence: 78%

Section: F I G U R Ementioning

confidence: 90%

Adjuvant therapy for rare rectal gastrointestinal stromal tumors: A case report

Chu,

Pu,

Chen

2024

Clinical Case Reports

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“…The study concluded that receiving imatinib therapy followed by surgical resection had better survival than the patients who underwent surgical resection without preceding chemotherapy. However, the disease-free survival in both groups was the same [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Rectal Gastrointestinal Stromal Tumors

Dawara¹,

Naureen²,

Keloth³

2023

Cureus

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Rectal gastrointestinal stromal tumors (GISTs) are rare types of tumors, but the incidence is increasing, and we now know more about the pathogenesis and management of rectal GIST. The main goal is to resect the tumor with negative microscopic margins. With the development of neoadjuvant Imatinib therapy, preoperative reduction in tumor size has become possible, thus introducing the chance for anus-preserving surgery, with better quality of life. We present a case of a 55-year-old female who presented to the emergency department with complaints of bleeding per rectum, abdominal pain, and pain on defecation. A 6-cm mass was detected during the rectal examination and a biopsy confirmed the diagnosis of GIST. The patient was given neoadjuvant imatinib chemotherapy for four months followed by trans-anal resection of the mass. The procedure was done successfully, and she received further adjuvant imatinib for a course of three years. Follow-up by magnetic resonance imaging and a colonoscopy after two years showed no recurrence. The patient is living healthily and doing well.

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“…This review focuses on these aspects of adjuvant therapy for GISTs. The neoadjuvant treatment of GISTs has been the topic of other recent reviews [24,25].…”

Section: Introductionmentioning

confidence: 99%

KIT and PDGFRA Variants and the Survival of Patients with Gastrointestinal Stromal Tumor Treated with Adjuvant Imatinib

Joensuu

2023

Cancers

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Adjuvant imatinib improves the recurrence-free survival and overall survival (OS) of patients with gastrointestinal stromal tumors (GISTs) who have a high risk of recurrence after surgery and is now considered standard treatment. Yet, OS benefit has been demonstrated in only one randomized study, the Scandinavian Sarcoma Group XVIII/AIO trial, where patients with high-risk GISTs were allocated to either 1 year or 3 years of adjuvant imatinib. SSGXVIII/AIO is also the only randomized trial in which adjuvant imatinib duration exceeding 2 years was evaluated. In this trial, the 3-year treatment led to a 45% reduction in the risk of death during the first 10 years that followed random allocation even though some of the patients did not have GISTs at tumor histology review, had mutations now known to be imatinib-resistant or had non-localized disease at study entry. In the subgroup of patients who had KIT exon 11 deletion/indel mutation, the reduction in the risk of death was 66% in favor of the longer treatment. Proper patient selection is of crucial importance since many patients are cured with surgery. Little evidence for OS benefit is available from randomized trials for patients whose GIST harbors KIT exon 9 mutation, KIT insertion mutation, PDGFRA D842V mutation, or lacks KIT and PDGFRA mutations. Adjuvant imatinib improves OS substantially if high-risk GISTs can be identified, treatment duration is long enough, and GISTs harbor an imatinib-sensitive mutation.

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Comparison of prognosis between neoadjuvant imatinib and upfront surgery for GIST: A systematic review and meta-analysis

Cited by 6 publications

References 50 publications

Adjuvant therapy for rare rectal gastrointestinal stromal tumors: A case report

Adjuvant therapy for rare rectal gastrointestinal stromal tumors: A case report

Rectal Gastrointestinal Stromal Tumors

KIT and PDGFRA Variants and the Survival of Patients with Gastrointestinal Stromal Tumor Treated with Adjuvant Imatinib

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