Heikki Joensuu, MD, PhD, professor of oncology, Helsinki University Central Hospital, Finland, discusses the resistance to imatinib (Gleevec) found in high-risk patients with gastrointestinal stromal tumors (GIST). This information was discovered in the SSGXVIII/AIO study that examined 3-year treatment of adjuvant imatinib compared to single year treatment as the new standard of care for high-risk GIST patients.

Dr. Joensuu says resistance to imatinib is a big problem when treating patients with advanced GIST. Most patients will develop other tumors and develop resistance to imatinib within a few years. In the SSGXVIII/AIO study, researchers observed very few patients who recurred while they were on imatinib: 4 in the one year arm, and 12 in the three year arm. When they went back to look at the type of mutations those particular patients had, some had wild-type GIST and others had a mutation that is not very sensitive to imatinib. There were very few recurrences while patients were on imatinib and those patients had mutations that were not that responsive. In some, the resistance problem was small.

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Dr. Heikki Joensuu from the Helsinki University Central Hospital Discusses Resistance to Imatinib in GIST

Dr. Joensuu Discusses Resistance to Imatinib in GIST

Heikki Joensuu, MD, PhD, professor of oncology, Helsinki University Central Hospital, Finland, discusses the progress of gastrointestinal stromal tumors (GIST) treatments in the past decade. The first patient was treated with imatinib (Gleevec) in 2000, with results released in 2001. This was only 10 years ago and many changes have accelerated therapy for this disease since that point. There has been substantial progress in a very short period of time.

Dr. Heikki Joensuu from the Helsinki University Central Hospital Discusses the Progress of gastrointestinal stromal tumors (GIST) Treatments

Dr. Joensuu Discusses the Progress of GIST Treatments

Heikki Joensuu, MD, PhD, professor of oncology, Helsinki University Central Hospital, Finland, discusses the randomized phase III trial that looked at imatinib (Gleevec) after surgery in patients with high-risk gastrointestinal stromal tumors (GIST).

The trial compared two arms, one with patient receiving imatinib for 1 year and the other receiving the drug for 3 years. The primary endpoint of the trials was recurrence-free survival (RFS). The 3-year arm demonstrated superior improvement in RFS and improved 5-year overall survival benefits of 92% vs 81.7% in the 1-year arm.

An important note for this trial is that it examined high-risk GIST patients that experience recurrence in approximately 50% of cases. This trial demonstrated a 5-year RFS of 65.6% in the 3-year arm and 47.9% in the other.

Dr. Heikki Joensuu from the Helsinki University Central Hospital Summarizes the Imatinib for High-Risk high-risk gastrointestinal stromal tumors (GIST) Trial

Heikki Joensuu, MD, PhD

Articles

Dr. Joensuu Discusses Resistance to Imatinib in GIST

Dr. Joensuu Discusses the Progress of GIST Treatments

Dr. Joensuu on the Imatinib for High-Risk GIST Trial