Adjuvant therapy with imatinib mesilate in a patient with intermediate risk GIST

The presented case regards a 63-year-old male patient who underwent radical surgery for an intermediate risk gastrointestinal stromal tumor (GIST) and thereafter was treated with imatinib mesilate at a daily dose of 400 mg for one year. Adjuvant therapy for primary GIST has proven benefit in extending relapse free survival in randomised controlled phase III trials; the advantage in overall survival, however, is yet to be proved. Defined risk factors for recurrence are based on GIST size, location, and mitotic rate provide useful guidelines for selecting patients for adjuvant therapy considerations. Nevertheless, it is currently unclear how to select those patients who would benefit the most, which is the optimal dose and treatment duration, and, importantly, if the use of adjuvant imatinib could enhance the chance of cure. The case report will be used as a paradigmatic springboard for further discussion.