Prospective Multicentric Randomized Phase III Study of Imatinib in Patients With Advanced Gastrointestinal Stromal Tumors Comparing Interruption Versus Continuation of Treatment Beyond 1 Year: The French Sarcoma Group

Abstract

Imatinib interruption results in rapid progression in most patients with advanced GIST, and cannot be recommended in routine practice unless patient experience significant toxicity

Determinación inmunohistoquímica y utilidad pronóstica del receptor del factor de crecimiento epidérmico en los tumores estromales gastrointestinales

“…La expresión de EGFR en los GIST, también posibilitaría la introducción de nuevas terapias ante situaciones de resistencia al mesilato de imatinib o bien como tratamiento coadyuvante. Las líneas terapéuticas para conseguir la inhibición del EGFR incluye moléculas que inhiben el dominio intracelular tirosina quinasa, anticuerpos monoclonales que actúan sobre el dominio extracelular del EGFR, y la combinación de inhibidores del factor de crecimiento del endotelio vascular (VEGF) e inhibidores de EGFR (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26).…”

Le futur des thérapeutiques ciblées en oncologie : trouver les cibles, traiter tôt et au long cours

“…Le deuxième groupe rassemble les thérapeutiques ciblées sur des anomalies moléculaires qui contribuent à la progression tumorale mais ne constituent pas l'étape initiale de la transformation : les thérapeutiques anti-angiogéniques, et les inhibiteurs de HER2 (human epidermal growth factor receptor-2) dans le cancer du sein avancé en sont des exemples représentatifs. Ces thérapeutiques donnent des taux de réponse limités en monothérapie, une survie sans progression de durée moyenne (typiquement 6 à 12 mois), une survie globale voisine souvent de 12 à 24 mois [4][5][6][7]. L'immunothérapie représente une troisième catégorie.…”

Optimizing Tyrosine Kinase Inhibitor Therapy in Gastrointestinal Stromal Tumors: Exploring the Benefits of Continuous Kinase Suppression

“…Interruption of imatinib treatment after 1 year resulted in increased disease progression in 26 of 32 patients (81%) compared with 8 of 26 patients (31%) who continued treatment after 1 year (p Յ .0001) [15]. Similarly, progression-free survival (PFS) was significantly increased in patients who continued imatinib after 3 years; the 2-year PFS was 80% for patients in the continuation group versus 16% (p Ͻ .0001) in the interruption group (Fig.…”

“…1). Notably, the increased risk of relapse associated with imatinib interruption after 1 year or 3 years of treatment was observed even in patients who achieved complete response (CR) before randomization [15,16]. Treatment interruption after 5 years of imatinib also resulted in rapid disease progression in the majority of patients: 45% of patients experienced disease relapse, whereas no disease progression was observed in patients randomized to the continuation arm (p ϭ .035) [18].…”

“…The BFR14 randomized phase III study conducted by the French Sarcoma Group assessed the impact of interrupting therapy after 1 year, 3 years, or 5 years of daily treatment with 400 mg of imatinib in patients with advanced GIST [15][16][17][18]. Interruption of imatinib treatment after 1 year resulted in increased disease progression in 26 of 32 patients (81%) compared with 8 of 26 patients (31%) who continued treatment after 1 year (p Յ .0001) [15].…”