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Gastroenterology Research and Practice
Volume 2014 (2014), Article ID 342986, 6 pages
http://dx.doi.org/10.1155/2014/342986
Research Article

Impact of Rechallenge with Imatinib in Patients with Advanced Gastrointestinal Stromal Tumor after Failure of Imatinib and Sunitinib

1Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya-shi, Aichi 464-8681, Japan
2Digestive and General Surgery 2 Division, Niigata University Hospital, 754 Ichibancho, Asahimachidori, Chuo-ku, Niigata-shi, Niigata 951-8510, Japan
3Department of Cancer Chemotherapy, Hokkaido University Hospital, Cancer Center, Kita 14-jo Nishi 5-chome, Kita-ku, Sapporo-shi, Hokkaido 060-8648, Japan
4Department of Surgery, Osaka University, School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan

Received 7 May 2013; Accepted 27 December 2013; Published 22 January 2014

Academic Editor: Paul Enck

Copyright © 2014 Akira Sawaki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. This retrospective, nonrandomized study investigated the effect of imatinib rechallenge plus best supportive care (BSC) on overall survival after imatinib and sunitinib treatment for patients with locally advanced or metastatic gastrointestinal stromal tumor (GIST). Methods. Twenty-six patients who had previously been exposed to both imatinib and sunitinib were enrolled in this study. The treatment regimen was BSC with or without imatinib, based on the patient’s choice after discussion with his or her physician. The primary endpoint was overall survival, and secondary endpoints were time to treatment failure, clinical response rate assessed by Choi criteria, and safety. Results. Fourteen patients were treated with imatinib plus BSC and 12 received BSC alone. Median overall survival was greatly improved for the imatinib group, although differences were not significant (22 months for imatinib plus BSC versus 4 months for BSC; ). Three patients (21%) had a clinical response in the imatinib group, and one had a clinical response in the BSC alone group. Imatinib was well tolerated. Conclusions. Rechallenge with imatinib may be associated with improvement in overall survival without deteriorating performance status in patients who failed imatinib and sunitinib. A prospective study should be considered to confirm the efficacy of rechallenge with imatinib.