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- W2274127002 abstract "15505 Introduction: Quality of surgical resection is an important prognostic factor for gastrointestinal stromal tumor (GIST) and large GIST has a worse prognosis because resection is often marginal. We conducted a registered multicentric phase II trial to evaluate the efficacy of imatinib when administered preoperatively. Material and Methods: The trial was opened in 7 centers and forty-four patients were planned to be included. An interim analysis was done after 16 patients. Patients were considered eligible if they had a kit (CD-117) positive gist with a risk of an incomplete resection of 20 percent or higher (tumor attached to 3 or more adjacent organs or larger than 10 cm) or if surgery with high morbidity was planned. Imatinib was started at 400 mg po id and increased to 600 mg po id if response to treatment was not sufficient. Response to treatment was measured according to recist criteria at 6 and 12 weeks, and then every 8 weeks until best response had been reached for a maximum of 52 weeks. Surgery was planned to be performed between 6 and 12 months of neoadjuvant treatment. Results: Between 2005 and 2007, 16 patients were enrolled. Gist originated from the stomach in 9 patients, esophagus in 1 and small bowel in 6. Twelve patients completed the study. Six patients underwent r0 surgery after partial response (pr) with 400 mg for 12 months. Four had an initial progressive disease (pd) and then received 600 mg (one partial response (pr), 2 stable disease (sd) and one progression). One pr patient had surgery at 8 weeks for gastrointestinal bleeding and one cr patient refused surgery. Four patients are still under treatment and have pr. At surgery (n=11), residual tumor cells were found in all patients. An r0 resection was possible in 9 patients and the surgical strategy was changed in 8 patients. Conclusion: Imatinib 400 mg is efficient as neoadjuvant treatment for patients with large gist but cr is rare (1/12), even when 600 mg is used. In this series, neoadjuvant treatment with imatinib led to a more conservative surgical resection in 72% of patients and to an r0 resection in 81% of them. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration AstraZeneca Oncology, Novartis, Roche, sanofi-aventis AstraZeneca Oncology, Novartis, Roche, sanofi-aventis" @default.
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- W2274127002 date "2008-05-20" @default.
- W2274127002 modified "2023-09-25" @default.
- W2274127002 title "Preoperative administration of imatinib in patients with large gastrointestinal stromal tumors can change surgical strategy and improve the quality of resection in most patients: Clinical results of gap study" @default.
- W2274127002 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.15505" @default.
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