This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar content in this book Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cassier, P. A. Articles by Blay, J.-Y. Search for Related Content PubMed Articles by Cassier, P. A. Articles by Blay, J.-Y.

Controversies in the Adjuvant Treatment of Gastrointestinal Stromal Tumors (GIST) with Imatinib

From the ¹ Unité de Jour d’Oncologie Médicale Multidisciplinaire, Hôpital Edouard Herriot, Lyon, France; ² Département de médecine & Unité INSERM U590, Centre Léon Bérard, Lyon, France

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

Address reprint requests to Jean Yves Blay, MD, PhD, Unité de Jour d’Oncologie Médicale Multidisciplinaire, Pavillon E, Hôpital Edouard Herriot, 5 place d’Arsonval, 69003, Lyon; e-mail: blay{at}lyon.fnclcc.fr

Overview: The molecular hallmark of gastrointestinal stromal tumors (GIST) was discovered 10 years ago. Since then, they have become a model for the targeted treatment of solid tumors, with imatinib and sunitinib becoming the standard first-line and second-line treatments of these tumors, respectively. Because of high efficacy of imatinib treatment in the advanced setting, several phase III trials have been initiated to address the role of adjuvant imatinib treatment following resection of primary GIST. In 2007, the American College of Surgeons Oncology Group (ACOSOG) Z9001 was the first study to report a significant improvement in progression-free survival, but not overall survival, in patients with tumors larger than 3 cm. This chapter will review the knowledge of clinical, biologic, and therapeutic aspects of this disease and will discuss controversies in the use of imatinib in the adjuvant setting.