Length of adjuvant imatinib therapy in GIST: Weighing benefits,side effects and costs

Abstract

A recent large randomized clinical trial showed a survival advantage with 36 vs 12 months of adjuvant imatinib in patients with resected gastrointestinal stromal tumors (GISTs). However, there was a higher therapy discontinuation rate with the longer duration of treatment. Preferences of individual GIST patients and the imatinib risk/benefit ratio should always be sought before employing this agent in adjuvant setting for longer than 12 months. A shorter duration of therapy may be preferred in patients with a limited life expectancy, serious cardiovascular co-morbidities, diminished compliance or poor adherence to oral therapy. Further study of underlying economic, psychosocial, and physical barriers of longer vs shorter duration of adjuvant therapy in this patient population is probably warranted.

Keywords

Imatinib GIST adjuvant therapy side effect cost

Get full access to this article

View all access options for this article.

References

Savage

. Development and economic trends in cancer therapeutic drugs in the UK from 1955 to 2009. J Oncol Pharm Pract 2012; 18: 52–56.

Joensuu

Eriksson

Hall

. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA 2012; 307: 1265–1272.

Blanke

. Optimal duration of adjuvant therapy for patients with resected gastrointestinal stromal tumors. JAMA 2012; 307: 1312–1314.

Dasanu

Padmanabhan

Clark

3rd . Cardiovascular toxicity associated with small molecules tyrosine kinase inhibitors currently in clinical use. Exp Opin Drug Saf 2012; 11: 445–457.

Kerkela

Grazette

Yacobi

. Cardiotoxicity of the cancer therapeutic agent imatinib mesylate. Nat Med 2006; 12: 908–916.