Adjuvant treatment of gastrointestinal stromal tumor: State of the art in 2025

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2025-04-26 DOI:10.1016/j.ejca.2025.115473

Nicolas Penel , Axel Le Cesne , Jean-Yves Blay

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Abstract

The management of gastrointestinal stromal tumors (GISTs) has been revolutionized by the discovery of their sensitivity to imatinib. Most localized GISTs can be cured by surgery alone. The present overview aims to discuss the results of four recent randomized trials or updates assessing adjuvant imatinib. The duration of adjuvant treatments varied in these 4 trials (1 year versus zero, 2 years versus zero, 3 years versus 1 year and 6 years versus 3 years). All these trials showed that adjuvant imatinib improves disease/relapse-free survival in patients at high-risk of GIST relapse. Nevertheless, only one trial showed an overall survival improvement, in favor of 3-year treatment compared to 1-year treatment. But these randomized trials did not assess KIT or PDGFRA mutational status at study entry. Moreover, the definition of high-risk GIST differed across these trials. So, the patient subset that benefits the most from adjuvant imatinib therapy remains undetermined. The optimal duration of adjuvant imatinib therapy remain unclear.

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胃肠道间质瘤的辅助治疗：2025年的最新进展

胃肠道间质瘤（gist）的管理已经革命性的发现他们对伊马替尼的敏感性。大多数局部gist仅通过手术即可治愈。本综述旨在讨论最近评估辅助伊马替尼的四项随机试验或更新的结果。在这4个试验中，辅助治疗的持续时间各不相同（1年vs零，2年vs零，3年vs 1年，6年vs 3年）。所有这些试验都表明，辅助伊马替尼可改善GIST复发高风险患者的疾病/无复发生存。然而，只有一项试验显示总体生存改善，3年治疗优于1年治疗。但是这些随机试验没有评估KIT或PDGFRA在研究开始时的突变状态。此外，高风险GIST的定义在这些试验中存在差异。因此，从辅助伊马替尼治疗中获益最多的患者亚群仍未确定。伊马替尼辅助治疗的最佳持续时间尚不清楚。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

期刊介绍： The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.