Dr. Trent on the Role of Adjuvant Imatinib in GIST

Jonathan C. Trent, MD, PhD, professor and associate director for Clinical Research at the Sylvester Comprehensive Cancer Center, University of Miami Health System, discusses the role of adjuvant imatinib (Gleevec) in gastrointestinal stromal tumors (GIST).

 Surgery is the mainstay of treatment for patients with a primary GIST; however, surgery alone is not always effective, explains Trent. Notably, about 50% of patients will experience disease recurrence after surgery. Oftentimes, these recurrences occur as metastatic disease, Trent says.

Over the years, a number of trials emerged that provided the space with greater insight, including a study that evaluated 2 years of adjuvant imatinib, says Trent. Results of the study showed that adjuvant imatinib was more effective versus no adjuvant therapy. More recently, a phase 3 study from the Scandinavian Sarcoma Group (NCT00116935) demonstrated that 3 years of imatinib after surgery can increase progression-free survival and overall survival compared with 1 year of imatinib in patients with GIST. As such, when treating patients with high-risk GIST, adjuvant therapy with imatinib is now the standard of care. Additionally, neoadjuvant therapy is often implemented as a means to decrease tumor size and allow for organ-sparing surgery, Trent concludes.