Oncology Medical News about GI stromal tumors, imatinib mesylate

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Absence of progression as assessed by response evaluation criteria in solid tumors predicts survival in advanced GI stromal tumors treated with imatinib mesylate: the Intergroup EORTC-ISG-AGITG phase III trial
Journal of Clinical Oncology, 07/23/09

Le Cesne A et al. - In a study to investigate whether the response classification assessed by Response Evaluation Criteria in Solid Tumors (RECIST) predicts for time to progression (TTP) and overall survival (OS), it was shown that RECIST perfectly enables early discrimination between pts who benefited long term from imatinib and those who did not. After 6 mos of imatinib, if the pt is not experiencing progressive disease (PD), the pattern of radiologic response by tumor size criteria has no prognostic value for further outcome. Imatinib needs to be continued as long as there is no progression according to RECIST.

Methods

The first 3 disease assessments were done at 2, 4, and 6 mos.
For the purpose of the analysis, disease response was subclassified in 6 categories: partial response (PR; >30% size reduction), minor response (MR; 10% to 30% reduction), no change (NC) as either NC- (0% to 10% reduction) or NC+ (0% to 20% size increase), PD (>20% increase/new lesions), and subjective PD (clinical progression).

Results

906 pts had measurable disease at entry.
At all measurement time points, complete response (CR), PR, and MR resulted in similar TTP and OS; this was also true for NC- and NC+, and for PD and subjective PD.
Pts were subsequently classified as responders (CR/PR/MR), NC (NC+/NC-), or PD.
This 3-class response categorization was found to be highly predictive of further progression or survival for the first 2 measurement points.
After 6 mos of imatinib, responders (CR/PR/MR) had the same survival prognosis as pts classified as NC.

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