Imatinib as adjuvant treatment following resection of KIT-positive gastrointestinal stromal tumours

Dretzke J, Round J, Connock M, Tubeuf S, Pennant M, Fry-Smith A, Hulme C, McCabe C, Meads C
Record ID 32011000983
English
Authors' recommendations: A survival benefit with adjuvant imatinib has to date not been shown. There is a lack of good long-term evidence around the rate of imatinib resistance over time with different treatment strategies (± adjuvant imatinib, for 1 year or 3 years), and the effect on overall survival. There are serious concerns around the validity and application in the manufacturer’s model of a number of input parameters, such as utilities and monthly probabilities of death. The model also makes a basic assumption that any benefit in delay of recurrence translates directly into an increase in survival over the long term; this assumption is not supported by any evidence and does not take into account the possibility of differing rates of Imatinib resistance between the two treatment arms. Due to the large number of uncertainties and assumptions, the estimated ICERs should be regarded as highly uncertain. It is possible that results from ongoing trials will inform this issue. The EORTEC 62024 trial10 in particular has as an end point time to imatinib resistance, which may be a more usefulproxy for overall survival. Should adjuvant imatinib treatment be shown to be beneficial in the future, further research would also be required into the type of patient most likely to benefit from adjuvant treatment based on mutational analysis.
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/erg/supplements/supplement1402.pdf#nameddest=article09
Year Published: 2010
URL for published report: http://www.hta.ac.uk/2173
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Benzamides
  • Cost-Benefit Analysis
  • Imatinib Mesylate
  • Randomized Controlled Trials as Topic
  • Antineoplastic Agents
  • Gastrointestinal Stromal Tumors
  • Piperazines
  • Proto-Oncogene Proteins c-kit
  • Pyrimidines
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2010 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.