Surgery After Treatment with Imatinib Lengthens Lives for Patients with Metastatic or Recurrent GIST

Gastrointestinal Cancers Symposium
January 22, 2013

A recent study showed that patients with gastrointestinal stromal tumor (GIST) who received surgery to remove any tumors remaining after treatment with the drug imatinib (Gleevec) lived longer and were less likely to have their disease worsen than patients who received only imatinib. Imatinib is a type of targeted therapy, a treatment that targets the tumor’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. It is usually the first treatment for GIST that is metastatic (cancer that has spread) or recurrent (cancer that has come back after treatment), and works to treat the disease for about 80% to 85% of patients. However, most patients have tumors remaining after treatment with imatinib. These remaining tumors are thought to cause the disease to become resistant to imatinib, which means that the drug stops controlling the tumor’s growth. For this reason, researchers believed removing the remaining tumors with surgery would help prevent the tumor from becoming resistant to imatinib.

In this study, researchers analyzed information from 92 patients who received imatinib only and 42 patients who received surgery after treatment with imatinib. They found that it took almost four years longer for the disease to worsen in the patients who received surgery after imatinib when compared with those who received only imatinib. They also found that patients who received surgery were five and a half times less likely to die from the disease than those who received only imatinib.

Researchers also found that specific features were linked with a longer survival and lower risk of the disease worsening. These features included having fewer and/or smaller tumors, being a woman, and a specific change in a gene called KIT. Previous research has shown that imatinib works better in tumors that have a change to the KIT gene.

What this means for patients

“Many doctors think that adding surgery is beneficial to the patient if imatinib is working, but there is little research showing this,” said Seong Joon Park, MD, the lead study author with Asan Medical Center in Seoul, South Korea. “This study suggests that surgery substantially lengthens the lives of patients with metastatic or recurrent GIST.” It’s important to talk with your doctor about your diagnosis, the best treatment options for you, and how the recommended treatments will affect your chance of recovery.

Questions to Ask Your Doctor

  • What is my exact diagnosis?
  • What are my treatment options?
  • If imatinib stops working, are there additional treatments available?
  • Am I able to have surgery?
  • What clinical trials are open to me?

For More Information

Guide to Gastrointestinal Stromal Tumor

Understanding Targeted Treatments

Making Decisions About Cancer Treatment