Adjuvant Imatinib in High-risk Gastrointestinal Stromal Tumor (GIST) With C-kit Mutation

NCT ID: NCT00278876

Last Updated: 2020-01-07

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

47 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-04-30

Study Completion Date

2011-03-31

Brief Summary

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The presence of c-kit mutation is an independent poor prognostic factor for relapse in addition to large size (\> 5 cm) and high mitotic rate (\> 5/50 high power field \[HPF\]) in localized gastrointestinal stromal tumor (GIST) patients who underwent complete surgical resection. In addition, the localized GIST which had exon 11 c-kit mutation and features of high-risk for relapse according to National Institute of Health (NIH) consensus guideline (tumor size \> 10 cm or mitotic count \> 10/50 HPF) also have high-risk of relapse. Until recently, there has been no effective therapy for advanced, unresectable GISTs. However, a new agent, imatinib mesylate, has shown promise in the metastatic setting, and c-kit exon 11 mutation is the strongest prognostic factor for better response and survival. It is reasonable to try imatinib in an earlier and minimal residual status especially for patients at higher risk of relapse and a higher probability of response to imatinib.

Detailed Description

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Conditions

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Sarcoma Gastrointestinal Stromal Tumors

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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imatinib mesylate

patients receiving adjuvant imatinib mesylate

Group Type EXPERIMENTAL

Imatinib mesylate (Glivec)

Intervention Type DRUG

Imatinib mesylate 400mg/day per oral (day 1-28) every 4 weeks

Interventions

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Imatinib mesylate (Glivec)

Imatinib mesylate 400mg/day per oral (day 1-28) every 4 weeks

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically proven diagnosis of GIST, with positive immunostaining for KIT (CD117)
* Tumor size \> 5 cm and mitotic rate \> 5/50HPF(High Power Field), or tumor size \> 10 cm irrespective of mitotic rate, or mitotic rate \> 10/50 HPF irrespective of tumor size.
* Presence of mutation in exon 11 of c-kit gene.
* Surgery performed from 3 weeks to 8 weeks before administration of Imatinib mesylate.
* No evidence of residual macroscopic and microscopic disease after surgery.
* Absence of distant metastases
* No prior radiation therapy, no prior chemotherapy, no prior therapy with Imatinib mesylate, or any other molecular targeted or biological therapy.
* Age 18 yrs or older
* ECOG(Eastern Cooperative Oncology Group electrocorticogram) performance status = 0-2
* No New York Heart Association (NYHA) Class 3\~4 cardiac problems
* Absence of severe and/or uncontrolled concurrent medical disease (e.g., uncontrolled diabetes, uncontrolled chronic renal disease, uncontrolled liver disease, including chronic viral hepatitis judged at risk of reactivation, uncontrolled active infection, such as human immunodeficiency virus (HIV) infection, etc.).
* No ongoing pregnancy or nursing..
* No prior, or ongoing other malignancy, except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer or adequately treated cancer with eradicative intent for which the patient has been continuously disease-free for 5 years.
* No use of coumarin derivatives at the time of treatment start.
* Adequate liver function, as defined by a serum bilirubin \< 1.5 x the institutional upper limit of normal (IULN), aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \< 2.5 IULN, obtained within 7 days prior to randomization.
* Adequate renal function, as defined by a serum creatinine \< 1.5 x IULN, obtained within 7 days prior to randomization.
* Absolute neutrophil count (ANC) \> 1.5 x 109/l and a platelet count \> 100 x 109/l obtained within 7 days prior to randomization. Baseline hemoglobin \> 9 g/dl (this may be achieved by transfusions if needed).
* Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Asan Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Yoon-Koo Kang

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yoon-Koo Kang, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Asan Medical Center

Locations

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National Cancer Center

Goyang, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Seoul Samsung Medical Center

Seoul, , South Korea

Site Status

Countries

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South Korea

Other Identifiers

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CSTI571BKR08

Identifier Type: -

Identifier Source: secondary_id

AMC0501

Identifier Type: -

Identifier Source: org_study_id

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