Imatinib Mesylate in Treating Patients With Unresectable or Metastatic Gastrointestinal Stromal Tumor

This is an interventional treatment trial for Gastrointestinal Stromal Tumor focused on measuring gastrointestinal stromal tumor Read More

DISEASE CHARACTERISTICS:

• Histologically confirmed gastrointestinal stromal tumor (GIST)

  • Metastatic or unresectable disease
• Immunohistochemical confirmation of KIT (CD117) expression by tumor as documented by DAKO antibody staining

• Measurable or non-measurable disease by conventional imaging (CT scan or MRI) or physical examination

  • If a target lesion has been previously embolized or irradiated, there must be objective evidence of progression to be considered for response assessment
• No known brain metastasis

PATIENT CHARACTERISTICS:

• WHO performance status 0-3
• Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• AST and ALT ≤ 2.5 times ULN (≤ 5 times ULN if hepatic metastases are present)
• Creatinine ≤ 1.5 times ULN
• ANC ≥ 1,000/mm³
• Platelet count ≥ 100,000/mm³
• Hemoglobin ≥ 9 g/dL (transfusions allowed)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective barrier contraception during and for up to 3 months after completion of study therapy
• No NYHA class III-IV cardiac disease
• No congestive heart failure or myocardial infarction within the past 2 months
• No severe and/or uncontrolled concurrent medical disease (e.g., uncontrolled diabetes, uncontrolled chronic renal or liver disease, or active uncontrolled infection [e.g., HIV])
• No other prior malignancy except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for 5 years
• No medical, psychological, familial, sociological, or geographical condition that, in the opinion of the investigator, may preclude the patient's ability to tolerate or complete study treatment, comply with study protocol and follow-up schedule, or give reliable informed consent

PRIOR CONCURRENT THERAPY:

• Recovered from all prior therapy
• More than 28 days since prior chemotherapy, biologic therapy, or any other investigational drug
• More than 14 days since prior major surgery

• No concurrent therapeutic anticoagulation with coumarin derivatives

  • Concurrent therapeutic anticoagulation with low-molecular weight heparin allowed
  • Concurrent mini-dose coumarin derivatives (i.e., equivalent to 1 mg of oral warfarin daily) as prophylaxis allowed
• No concurrent cytokines (i.e., filgrastim [G-CSF] or sargramostim [GM-CSF]) to support blood counts
• No other concurrent investigational drugs
• No other concurrent anticancer agents, including chemotherapy, radiotherapy, or anticancer biologic therapy