{"id":46783,"date":"2024-09-19T12:00:00","date_gmt":"2024-09-19T12:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2024\/gist-uninterrupted-gleevec-treatment"},"modified":"2024-11-03T15:11:47","modified_gmt":"2024-11-03T15:11:47","slug":"clinical-trial-results-support-uninterrupted-use-of-imatinib-for-some-gastrointestinal-stromal-tumors","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/clinical-trial-results-support-uninterrupted-use-of-imatinib-for-some-gastrointestinal-stromal-tumors\/","title":{"rendered":"Clinical Trial Results Support Uninterrupted Use of Imatinib for Some Gastrointestinal Stromal Tumors"},"content":{"rendered":"

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GIST can develop in multiple parts of the gastrointestinal system, although it most commonly occurs in the stomach.<\/p>\n

Credit: Adapted from \u00a9 Terese Winslow<\/p>\n<\/p><\/div>\n<\/figcaption><\/figure>\n<\/p><\/div>\n

People receiving imatinib (Gleevec)<\/a> as a treatment for some advanced gastrointestinal stromal tumors (GISTs) should continue the therapy without interruption until the disease gets worse, according to new results from a clinical trial.<\/p>\n

The trial, conducted in France, included people with advanced GIST who were treated for 1, 3, or 5 years with imatinib. Participants whose tumors had stopped growing, had shrunk, or had gone away at the end of the treatment period were randomly assigned to continue or stop imatinib until the disease progressed (that is, began to grow or got worse) and were followed for up to 20 years.<\/p>\n

The participants who stopped imatinib at the end of all treatment periods experienced a more rapid worsening of the disease<\/a>, a shorter time until imatinib stopped working (resistance), and did not live as long as participants who continued the therapy, researchers reported in Lancet Oncology<\/em> on August 7.<\/p>\n

These findings affirm expert recommendations that most people with advanced GIST should remain on imatinib therapy without interruption, noted the trial\u2019s lead investigator, Jean-Yves Blay, M.D., of Centre L\u00e9on B\u00e9rard in Lyon, France.<\/p>\n

\u201cThe discontinuation of imatinib therapy should be discouraged unless there are very good medical reasons to do so,\u201d Dr. Blay said.<\/p>\n

The authors of an accompanying editorial<\/a> agreed. If imatinib is working for people with advanced GIST, \u201cdon\u2019t stop a good thing,\u201d wrote Ryan Denu, M.D., Ph.D., and Neeta Somaiah, M.D., of the University of Texas MD Anderson Cancer Center.<\/p>\n

Conversations about a treatment holiday<\/h2>\n

Imatinib, a type of treatment known as a tyrosine kinase inhibitor, has long been the standard initial treatment for people with advanced GIST. Although imatinib can shrink tumors, the cancer eventually becomes resistant to the drug and starts growing again.<\/p>\n

Other factors that limit how long patients receive imatinib include the cost of the drug and side effects, such as nausea and vomiting, that can affect a person\u2019s quality of life, according to the researchers.<\/p>\n

Given these issues, \u201cit\u2019s natural for patients to have questions about getting a treatment break,\u201d said Andrew Blakely, M.D., of NCI\u2019s Center for Cancer Research, who is a GIST specialist but was not involved in the study.<\/p>\n

U.S. and European guidelines generally recommend that patients with advanced GIST continue imatinib indefinitely as long as they can tolerate the side effects of therapy and the disease remains stable. The new findings support this approach while adding additional insights.<\/p>\n

The study highlighted the fact \u201cthat patients who reach 3 years without disease progression on imatinib have a higher likelihood of better outcomes on long-term imatinib,\u201d the editorialists wrote.<\/p>\n

\u201cWe did not expect the interruption of imatinib to have a detrimental effect on the risk of drug resistance and survival,\u201d Dr. Blay said.<\/p>\n

All trial results favored uninterrupted treatment<\/h2>\n

In the clinical trial, called BFR14, the researchers enrolled people with advanced GIST that could not be treated surgically or had spread. All participants began treatment with imatinib and, as long as their cancers didn\u2019t start to get worse, stayed on it for at least 1 year. The researchers then randomly assigned patients to continue or discontinue treatment.<\/p>\n

They repeated this random assignment for patients who continued to have stable disease after 3 and 5 years of treatment. In all cases, those assigned to stop treatment could resume it if their cancer started to grow again.<\/p>\n