Longer Drug Treatments for GI Cancer?

Gastrointestinal stromal cancer patients live longer with three years of Gleevec

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Newly published studies have begun to emphasize the effectiveness of combining several types of treatment for the best success in cancer therapy. This includes patients with gastrointestinal stromal cancers (GIST).

A four-year study found that patients at high risk for GIST recurrence responded well and lived longer when given Gleevec (imatinib) for three years, compared to those who were given the medication for only one year.

"Ask your oncologist about Gleevec."

In the group treated for three years, recurrence-free survival for five years was 65 percent, and overall survival at 92 percent. The one-year group had recurrence free survival for five years of 47 percent, and overall survival at 81 percent.

The study was based on patients throughout Germany, Finland, Norway and Sweden by a team from the Helsinki University Central Hospital.

GIST patients with a mutation known as KIT were followed for four years, from February 2004 to September 2008. Four hundred patients were split evenly between the group receiving a year of therapy and the group receiving three years of therapy.

Patients were randomized to receive imatinib, 400 mg per day, orally for either 12 months or 36 months, beginning within 12 weeks of surgery.

In the group treated for three years with imatinib, 25 percent of the patients quit the group, most commonly citing adverse effects. For similar reasons, citing cost and side effects, 12 percent of patients in the one year treatment group stopped participating in the study.

Researchers felt that their results were not conclusive, and that more studies should be performed before conclusions are drawn.

In an editorial accompanying the study data, Charles D. Blanke M.D., urged oncologists to give GIST cancer patients 400mg of imatinib per day for three years following surgery, if not forever.

Dr. Blanke believes the study sets the new standard of care, stating that "Laboratory biomarker studies may eventually provide information about which patients are unlikely to have recurrence...increasing patients' tolerance of even low-grade toxicities will be critical to improve their adherence to expensive treatments that could last for decades."

When purchased in brand name form, Gleevec (imatinib) may cost as much as $100,000 per year. Internationally, generic forms are sold at rates closer to $10,000 a year.

Gastrointestinal stromal cancers (GIST) can be found anywhere in the gastrointestinal tract and ranges from very aggressive to clinically benign.

Results were published online on March 28 in the Journal of the American Medical Association.

This study was funded by a mix of public and private funds, the pharmaceutical corporation Novartis Oncology provided the study drug as well as additional funding. Various foundations and academic institutions such as the Scandinavian Sarcoma Group; Academy of Finland; Cancer Society of Finland; Sigrid Jusetus Foundation; and Helsinki University Research Funds. Dr. Blanke reports consulting fees from Pfizer and Novartis.

Reviewed by: 
Review Date: 
March 28, 2012
Last Updated:
April 10, 2012