English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

The discovery that oncogenic driver mutations in KIT and PDGFRA are not only causative in gastrointestinal stromal tumors (GIST) but also their Achilles heel has changed the landscape of systemic treatment for solid tumors. The benefit of the tyrosine kinase inhibitor (TKI) imatinib mesylate (Gleevec) in metastatic GIST is now unquestionable. There are 2 phase II and 2 phase III trials that have proven that imatinib extends life, prolonging median overall survival (OS) in advanced GIST from 9 months to more than 5 years.1–4 Given the remarkable activity of imatinib in metastatic GIST, it was applied in the adjuvant setting. The American College of Surgeons Oncology Group (ACOSOG) sponsored the phase III Z9001 trial comparing adjuvant imatinib to placebo following the complete resection of localized, primary GIST. The trial was stopped prematurely because of a large difference in recurrence-free survival (RFS) between the arms (1 year RFS 98 % on the imatinib arm vs 83 % on the placebo arm; p < .0001).5 Adjuvant imatinib was subsequently approved by the Food and Drug Administration. Recently, we published the long-term results of this trial (median follow-up of 74 months), which has provided additional insight into the optimal use of adjuvant imatinib.6 The major unresolved issues regarding adjuvant imatinib include (1) which patients should be treated, (2) what are the exact benefits, and (3) what is the optimal duration.

Adjuvant Imatinib for GIST: The Pie is Shrinking