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Sarcoma • Medical Oncology
For patients who received neoadjuvant Imatinib for initially unresectable GIST tumours, do you routinely prescribe adjuvant therapy or rely on preoperative staging and preoperative mitotic index?
NCCN suggests to consider continuation of imatinib from some single/multi institution non-randomized trials for ~2 years, but does not suggest what factors to consider in making this decision.
Answer from: Medical Oncologist at Academic Institution
One way to think about this is to consider the reason the patient needed to have neoadjuvant imatinib. This is likely because the tumor was too large and unresectable at the time. These patients are generally considered to be very high risk for recurrence even with optimal surgery and I would even c...
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Answer from: Medical Oncologist at Academic Institution
I agree with Dr Groisberg. Another way to look at it is that if the patient would have qualified by preoperative risk factors, I wouldn’t “downgrade” that by the improved risk tumor that comes out. Sometimes you can’t be sure ahead of time- for example I just saw a patient wi...