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The role of high‐dose imatinib in the management of patients with gastrointestinal stromal tumor
Author(s) -
Gronchi Alessandro,
Blay JeanYves,
Trent Jonathan C.
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.24944
Subject(s) - medicine , imatinib , stromal tumor , gist , stromal cell , imatinib mesylate , oncology , cancer research , myeloid leukemia
After an era of few treatment options for patients with locally advanced or metastatic gastrointestinal stromal tumor (GIST), imatinib has emerged as the standard of care and first‐line treatment for these patients. Although imatinib was initially approved at the doses of 400 and 600 mg daily, results from clinical studies established 400 mg daily as the standard initial dose for the majority of advanced GIST patients. Nevertheless, the use of high‐dose imatinib (800 mg daily) has been shown to benefit patients with advanced or metastatic GIST that progresses on the standard‐dose, and has been recommended in this setting by the major management guidelines in Europe and the United States. Results from the Meta‐GIST meta‐analysis showed that patients whose GIST harbors a KIT exon 9 mutation garner a longer progression‐free survival time when treated initially with high‐dose imatinib (800 mg daily) compared with those patients with KIT exon 11 or no mutations. Thus, the use of high‐dose imatinib is recommended by the clinical practice guidelines in these 2 specific clinical situations. In addition, clinicians should weigh the clinical benefit of administering high‐dose imatinib against the associated toxicities, as well as the proper management of dose‐related side effects. Cancer 2010. © 2010 American Cancer Society.