Abstract

OLIVEROS WILCHES, Ricardo; BONILLA CASTANEDA, Ana D; FACUNDO NAVIA, Helena  and  SANCHEZ PEDRAZA, Ricardo. For How Long Should Adjuvant Therapy for Gastrointestinal Stromal Tumors (GIST) Be Administered?. Rev Col Gastroenterol [online]. 2016, vol.31, n.4, pp.425-432. ISSN 0120-9957.

Surgery is the established treatment for patients with primary gastrointestinal stromal tumors (GIST) that are completely resectable. After surgery, up to 50% of patients suffer recurrences in the first two years. This is especially true for high risk patients. This is the justification for adjuvant therapy with imatinib (IMB). Based on clinical evidence, three years is the established treatment time for patients at high risk of recurrence. However, the same clinical studies also show that recurrences begin to be detectable six to nine months after discontinuation of the drug. We present the cases of three patients who underwent complete resection of GIST who then received imatinib for three years. Months after the medication was discontinued, recurrences required administration of the drug to be restarted. The optimal duration of adjuvant therapy with IMB has not been established, and it is unclear whether IMB actually cures the disease. For this reason, a review of how long adjuvant therapy with IMB should be administered and of what the effect of IMB on the disease really is was needed. In conclusion, on the basis of currently available evidence, we know that the recommendation is three years of treatment with IMB as adjuvant therapy, but, based on daily experience and expert recommendations, there are patients who probably need to continue treatment with imatinib for much longer while we wait for reports of the results of clinical studies of five year IMB treatment.

Keywords : Gastrointestinal stromal tumor; adjuvant therapy; imatinib, treatment; metastatic and/or advanced GIST; risk stratification, molecular profile; mutational state.

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