Management of gastrointestinal stromal tumors: looking beyond the knife. An update on the role of adjuvant and neoadjuvant imatinib therapy

J Gastrointest Cancer. 2012 Dec;43(4):547-52. doi: 10.1007/s12029-012-9423-0.

Abstract

Background: Gastrointestinal stromal tumors (GISTs) have traditionally been treated with surgical resection alone resulting in high rates of recurrence. However, the discovery of imatinib efficacy in GIST has revolutionized its management.

Discussion: Imatinib may be used as neoadjuvant therapy with the goal of reducing tumor size, minimizing surgical morbidity and, in some cases, rendering inoperable cases operable. In addition, imatinib use in the adjuvant setting to eradicate micrometastases and prevent recurrence has shown promising results in reducing relapse rates. Appropriate patient selection and optimal dose and duration of imatinib therapy remain undecided and require further investigation. We present a literature review and a case report of our patient with a symptomatic gastric GIST managed successfully utilizing neoadjuvant imatinib therapy, laparoscopic limited resection, and adjuvant imatinib therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Benzamides / administration & dosage
  • Benzamides / therapeutic use*
  • Chemotherapy, Adjuvant
  • Gastrointestinal Neoplasms / drug therapy*
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Neoplasms / surgery
  • Gastrointestinal Stromal Tumors / drug therapy*
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery
  • Humans
  • Imatinib Mesylate
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Piperazines / administration & dosage
  • Piperazines / therapeutic use*
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use*

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate