Longer Gleevec use extends GIST patient survival: MedlinePlus

Longer Gleevec use extends GIST patient survival




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Sunday, June 5, 2011
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Intestinal Cancer
By Bill Berkrot

NEW YORK (Reuters) - Taking the Novartis cancer drug Gleevec for three years following surgery to remove gastrointestinal stromal tumors (GIST) extended survival in more high-risk patients than the standard one year of Gleevec treatment, according to data released on Sunday.

GIST patients following surgery are now typically given Gleevec, known chemically as imatinib, for 12 months in an effort to delay spread or recurrence of the cancer.

The three-year course of therapy delayed recurrence of the disease in a significantly higher percentage of patients and helped more of them live at least five years, according to results of the study conducted by the Scandinavian Sarcoma Group.

"I consider it likely that the treatment guidelines will change based on the results, and the three-year treatment will likely become the standard," said Dr. Heikki Joensuu, the study's lead investigator who presented the data at the American Society of Clinical Oncology meeting in Chicago.

It should also increase sales of the Novartis medicine, which for a decade has been a highly successful treatment for leukemia.

"There was a highly significant difference in recurrence-free survival, and what was very important was the difference in overall survival in favor of the three-year treatment," added Joensuu, from Helsinki University Central Hospital in Finland.

In the 400-patient study, five-year recurrence-free survival was seen in 65.6 percent of those who received Gleevec for three years. That compared with 48 percent in the one-year group.

The overall survival rate was also higher with 92 percent of those who got three years of Gleevec therapy still alive after five years compared with 81.7 percent for those who took the Novartis pill for one year.

"Many patients survived for five years even though they had high-risk disease and some of them had very, very high risk," Joensuu said, explaining that 20 percent in the trial had previously suffered a tumor rupture in the abdominal cavity.

For those patients the risk of GIST coming back is more than 80 percent, maybe even more than 90, Joensuu said.

"In light of this background the 92 percent overall survival figure is fantastic," he said.

The dropout rate due to adverse side effects was higher in the three-year group -- 13.7 percent versus 7.7 percent.

Four patients in the 12-month group and 12 patients in the 36-month group stopped treatment due to GIST recurrence while receiving Gleevec.

GIST tumors, which usually begin in the stomach or intestine, are a type of soft-tissue sarcoma. GIST patients are at risk of recurrence even after successful surgery to remove tumors.

Gleevec targets abnormal proteins encoded in genes found in about 90 percent of GIST. About 85 percent of patients with advanced operable GIST typically respond to one year of Gleevec therapy, with partial remission or stable disease lasting a median of two years, researchers said.

The drug was generally well-tolerated with the majority of side effects typical of treatment with Gleevec, including anemia, fatigue, nausea, diarrhea and muscle cramps.

(Reporting by Bill Berkrot, editing by Matthew Lewis)

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Longer Gleevec use extends GIST patient survival: MedlinePlus