Efficacy and safety evaluation of two doses of imatinib for the treatment of advanced gastrointestinal stromal tumors (GISTs)

SummaryBackground and objectiveImatinib is approved worldwide for use in gastrointestinal stromal tumours (GISTs). To evaluate the efficacy and safety of two dose of imatinib treatment for patients with GISTs, a meta-analysis was performed.MethodsElectronic search of the PubMed and EMBASE, which have articles published between 1980 and February 2012, was conducted to select studies for this meta-analysis.ResultsFive articles with a total number 1861 of advanced GISTs patients were involved in this meta-analysis. There was a slight but significant 2-year PFS advantage with high-dose group (OR = 1.25, 95% CIs = 1.03–1.52, P = 0.03), but not in the 2-year OS (OR = 1.02, 95% CIs = 0.84–1.24, P = 0.87), CR (OR = 1.02, 95% CIs = 0.66–1.58, P = 0.93), and PR (OR = 1.13, 95% CIs = 0.94–1.36, P = 0.20). In safety, the high-dose group increased the incidence of above grade 3 toxicity (OR = 2.05, 95% CIs = 1.70–2.48, P < 0.00001), particular in the blood toxicity, skin disorders, nausea and so on.ConclusionsThis analysis confirms a slight 2-year PFS advantage of high-dose imatinib, but imatinib dose escalation could not lead to any other major clinical benefits, and brought more toxic effects for patients.