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Imatinib Dosing in Gastrointestinal Stromal Tumors (GISTs): When, How Much, and How Long?
Journal article

Imatinib Dosing in Gastrointestinal Stromal Tumors (GISTs): When, How Much, and How Long?

Mohammed Milhem and Jeremy M Deutsch
Current clinical pharmacology, Vol.10(4), pp.311-320
2015
DOI: 10.2174/1574884710666151020100518
PMID: 26548908

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Abstract

Imatinib therapy has revolutionized the treatment of patients with gastrointestinal stromal tumors (GISTs). Compared with older therapy, imatinib significantly improves outcomes in patients with metastatic disease and those with locally advanced tumors, raising progression-free and overall survival. Recent studies have evaluated variables such as timing of treatment, total dosing, and duration of therapy. Different genotypes are associated with a poorer response to imatinib therapy, whereas others may benefit from a higher starting dose. This review discusses recent data regarding optimal use of imatinib for treatment of GIST in both the adjuvant and metastatic settings, and addresses topics such as the impact of genotype on initial dose, dose escalation, optimal duration of treatment, and neoadjuvant therapy. Key ongoing clinical trials of imatinib in GIST are also discussed.
Drug Administration Schedule Gastrointestinal Neoplasms - drug therapy Humans Antineoplastic Agents - therapeutic use Antineoplastic Agents - administration & dosage Dose-Response Relationship, Drug Disease-Free Survival Gastrointestinal Neoplasms - pathology Protein Kinase Inhibitors - administration & dosage Imatinib Mesylate - therapeutic use Neoplasm Metastasis Time Factors Gastrointestinal Stromal Tumors - drug therapy Protein Kinase Inhibitors - therapeutic use Gastrointestinal Stromal Tumors - pathology Imatinib Mesylate - administration & dosage Survival Analysis

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