Imatinib Revolutionizes Treatment of Unresectable/Metastatic GI Stromal Tumors

MedicalResearch.com Interview with:

Michael C. Heinrich, MD Professor of Medicine and Cell and Developmental Biology Oregon Health & Sciences University

Dr. Michael Heinrich

Michael C. Heinrich, MD
Professor of Medicine and Cell and Developmental Biology
Oregon Health & Sciences University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prior to 2000, there were no effective medical treatments for advanced GI stromal tumor and patients faced an average life expectancy of 18 months or less.  In our study of the  long-term treatment results using imatinib (Gleevec),  we found that approximately 7% of patients were still on front-line therapy at 10 years without any evidence of tumor progression.  More importantly, the estimated 10 year survival was 23%.   Progression-free and overall survival rates were significantly higher for patients with KIT exon 11-mutant GIST when compared with patients with KIT exon 9-mutant or “wild-type” GIST (no KIT/PDGFRA mutations).

MedicalResearch.com: What should readers take away from your report?

Response: Based on its high response rate and durable effects on overall survival,  imatinib treatment has revolutionized the treatment of patients with unresectable/metastatic GI stromal tumor.  In addition, our findings highlight the importance of tumor mutation testing in optimizing treatment.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Although this study provides guidance for  management of GIST harboring the most common KIT and PDGFRA mutations, optimal management of other genotypic subtypes remains unclear.  Further therapeutic trials for patients with so called “wild-type GIST” are needed to determine the best treatment approaches for these patients. 

MedicalResearch.com: Is there anything else you would like to add?

Response: GIST is considered a rare cancer with approximately 6000 new cases diagnosed in the US annually. Our study indicates the feasability of academic cancer cooperative groups to successfully conduct research in rare diseases that lead to transformative advances in cancer therapy.

Disclosures:  Dr. Heinrich has stock/other ownership with MolecularMD; he has honoraria to report from Novartis and Pfizer ; he has consulting/advisory role with Novartis, Ariad, Blueprint; he has research funding from  Blueprint, Inhibikase, Ariad and Deciphera;  he has patent/intellectual property with Novartis (via his institution); he has provided expert testimony for Novartis.  

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Heinrich M, Rankin C, Blanke CD, Demetri GD, Borden EC, Ryan CW, von Mehren M, Blackstein ME, Priebat DA, Tap WD, Maki RG, Corless CL, Fletcher JA, Owzar K, Crowley JJ, Benjamin RS, Baker LH. Correlation of Long-term Results of Imatinib in Advanced Gastrointestinal Stromal Tumors With Next-Generation Sequencing ResultsAnalysis of Phase 3 SWOG Intergroup Trial S0033. JAMA Oncol. Published online February 09, 2017. doi:10.1001/jamaoncol.2016.6728

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior to 2000, there were no effective medical treatments for advanced GI stromal tumor and patients faced an average life expectancy of 18 months or less.  In our study of the  long-term treatment results using imatinib (Gleevec),  we found that approximately 7% of patients were still on front-line therapy at 10 years without any evidence of tumor progression.  More importantly, the estimated 10 year survival was 23%.   Progression-free and overall survival rates were significantly higher for patients with KIT exon 11-mutant GIST when compared with patients with KIT exon 9-mutant or “wild-type” GIST (no KIT/PDGFRA mutations).

 

MedicalResearch.com: What should readers take away from your report?

Response: Based on its high response rate and durable effects on overall survival,  imatinib treatment has revolutionized the treatment of patients with unresectable/metastatic GI stromal tumor.  In addition, our findings highlight the importance of tumor mutation testing in optimizing treatment.

 

 

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

 

Response: Although this study provides guidance for  management of GIST harboring the most common KIT and PDGFRA mutations, optimal management of other genotypic subtypes remains unclear.  Further therapeutic trials for patients with so called “wild-type GIST” are needed to determine the best treatment approaches for these patients.

 

 

 

MedicalResearch.com: Is there anything else you would like to add?

Response: GIST is considered a rare cancer with approximately 6000 new cases diagnosed in the US annually. Our study indicates the feasability of academic cancer cooperative groups to successfully conduct research in rare diseases that lead to transformative advances in cancer therapy.

 

Disclosures:  Dr. Heinrich has stock/other ownership with MolecularMD; he has honoraria to report from Novartis and Pfizer ; he has consulting/advisory role with Novartis, Ariad, Blueprint; he has research funding from  Blueprint, Inhibikase, Ariad and Deciphera;  he has patent/intellectual property with Novartis (via his institution); he has provided expert testimony for Novartis;

 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

 

Citation:

Correlation of Long-term Results of Imatinib in Advanced Gastrointestinal Stromal Tumors With Next-Generation Sequencing Results Analysis of Phase 3 SWOG Intergroup Trial S0033

 

 

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

 

 

 

Last Updated on February 12, 2017 by Marie Benz MD FAAD