Retrospective Analysis of Outcomes and Toxicity of Adjuvant Imatininb in Patients with Gastrointestinal Stromal Tumor in Clinical Oncology Department at Ain Shams University

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of GIT.75% of them are driven by mutations in the genes encoding for tyrosine kinase, KIT, (PDGFRA). Efficacy of the tyrosine kinase Inhibitors (imatinib) is approved for localized and advanced disease. For localized GISTs,3 years imtanib is the standard in the adjuvant settings for high risk patients after surgery.Aim of the Work: This review aims to describe current knowledge of adjuvant therapy of primary GISTs in view of available results and to refine the most commonly reported side effects of imatinibPatients and Methods: This study is a retrospective cohort study included 40 patients attending sarcoma clinic at the Clinical Oncology Department, Ain Shams University during the period from 1 January 2016 till 31 December 2022.Results: A total of 40 patients were included. 47.5% completed 3 year duration of treatment by Imatinib compared to 52.5% who didn't complete treatment duration.Higher DFS was found in the first group compared to the second group with median DFS 67.8 vs 47.9 months respectively P value <0.003 highly significant . As regard side effects of imatininb, toxicity was reported in 20% of the patients ,and the commonly found side effect was skin rash (12.5%) , followed by hematological toxicities (10 %), gastritis (5%) then diarrhea (2.5%) and elevated liver enzymes (2.5%) . 22.5% of patients developed recurrence of the disease and higher rate of reccurrence was found among elderly>60 years, tumor size>10 cm , and higher Ki67 with P value 0.001.Conclusion: Treatment with adjuvant Imatinib is proved to increase DFS with well tolerated side effects