Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 29:13:966486.
doi: 10.3389/fphar.2022.966486. eCollection 2022.

Comparison of prognosis between neoadjuvant imatinib and upfront surgery for GIST: A systematic review and meta-analysis

Zhen Liu  1 , Zimu Zhang  1 , Juan Sun  1 , Jie Li  1 , Ziyang Zeng  1 , Mingwei Ma  1 , Xin Ye  1 , Fan Feng  2 , Weiming Kang  1
Affiliations

Comparison of prognosis between neoadjuvant imatinib and upfront surgery for GIST: A systematic review and meta-analysis

Zhen Liu et al. Front Pharmacol. .

Abstract

Background: Significant survival benefit of adjuvant imatinib therapy has been observed in gastrointestinal stromal tumor (GIST). However, the impact of neoadjuvant imatinib on prognosis of GIST remains unclear. This meta-analysis aimed to compare the prognostic impact between upfront surgery and neoadjuvant imatinib plus surgery on GIST. Methods: A comprehensive literature search was performed to identify eligible studies up to 30 Sep 2021, through PubMed, Embase, Web of Science, and Cochrane Library. Studies compared the impact of upfront surgery and neoadjuvant imatinib plus surgery on disease-free (DFS) or overall survival (OS) in patients with GIST were selected. Results: Seven eligible studies with 17,171 patients were included. The reduction rates of tumor size in rectal and mixed site GIST were 33% and 29.8%, respectively. Neoadjuvant imatinib was not significantly associated with DFS compared with no-neoadjuvant therapy in rectal GIST (HR: 0.71, 95% CI: 0.35-1.41). The OS of rectal GIST was significantly improved by neoadjuvant imatinib compared with no-neoadjuvant therapy (HR: 0.36, 95% CI: 0.17-0.75). Conclusion: Neoadjuvant imatinib therapy contributed to tumor shrinkage and R0 resection of rectal GIST. Neoadjuvant imatinib plus surgery significantly improved overall survival of rectal GIST in comparison with upfront surgery.

Keywords: R0; gastrointestinal stromal tumor; meta-analysis; neoadjuvant imatinib; prognosis; upfront surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the search strategy.
FIGURE 2
FIGURE 2
Forest plots illustrating resection margin between neoadjuvant and no-neoadjuvant imatinib (A) and sensitivity analysis (B).
FIGURE 3
FIGURE 3
Forest plots illustrating disease-free survival between neoadjuvant and no-neoadjuvant imatinib (A) and sensitivity analysis (B).
FIGURE 4
FIGURE 4
Forest plots illustrating overall survival between neoadjuvant and no-neoadjuvant imatinib (A) and sensitivity analyses (B,C).
See this image and copyright information in PMC

References

    1. Andtbacka R. H., Ng C. S., Scaife C. L., Cormier J. N., Hunt K. K., Pisters P. W., et al. (2007). Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Ann. Surg. Oncol. 14, 14–24. 10.1245/s10434-006-9034-8 - DOI - PubMed
    1. Balduzzi S., Rucker G., Schwarzer G. (2019). How to perform a meta-analysis with R: A practical tutorial. Evid. Based. Ment. Health 22, 153–160. 10.1136/ebmental-2019-300117 - DOI - PMC - PubMed
    1. Blay J. Y., Serrano C., Heinrich M. C., Zalcberg J., Bauer S., Gelderblom H., et al. (2020). Ripretinib in patients with advanced gastrointestinal stromal tumours (INVICTUS): A double-blind, randomised, placebo-controlled, phase 3 trial. Lancet. Oncol. 21, 923–934. 10.1016/S1470-2045(20)30168-6 - DOI - PMC - PubMed
    1. Bonvalot S., Eldweny H., Pechoux C. L., Vanel D., Terrier P., Cavalcanti A., et al. (2006). Impact of surgery on advanced gastrointestinal stromal tumors (GIST) in the imatinib era. Ann. Surg. Oncol. 13, 1596–1603. 10.1245/s10434-006-9047-3 - DOI - PubMed
    1. Cai Z., Yin Y., Zhao Z., Xin C., Cai Z., Yin Y., et al. (2018). Comparative effectiveness of neoadjuvant treatments for resectable gastroesophageal cancer: A Network meta-analysis. Front. Pharmacol. 9, 872. 10.3389/fphar.2018.00872 - DOI - PMC - PubMed

Publication types

LinkOut - more resources