Adjuvant Imatinib Beyond 3 Years in High-Risk GIST: 5-Year Relapse-Free Survival OutcomesExtending Imatinib beyond 3 years did not improve survival for high-risk GIST patients

Frontiers in Medicine Published April 27, 2026 DOI ↗ Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway

Note: In this retrospective cohort, >3 years adjuvant imatinib improved 5-year RFS but not OS; findings require prospective validation.

In a single-center retrospective cohort at the First Affiliated Hospital of Chongqing Medical University, researchers evaluated 75 patients diagnosed with high-risk gastrointestinal stromal tumor (GIST) who underwent radical surgery. The primary comparison was adjuvant imatinib duration greater than 3 years versus 3 years or less, with a 5-year follow-up. The main outcome was 5-year relapse-free survival (RFS), and secondary outcomes included 5-year overall survival (OS) and plasma trough concentrations (Cmin) of imatinib.

Five-year RFS was 84% in the >3 years group versus 74% in the ≤3 years group (P < 0.05). Five-year OS did not differ significantly between groups (P > 0.05). Multivariate analysis found treatment duration not significantly associated with survival benefit (HR = 0.53, 95% CI 0.15–1.83, P = 0.313). The clinical significance of imatinib Cmin remains unclear.

Safety and tolerability were not reported; adverse events, serious adverse events, and discontinuations were not reported. Key limitations include the retrospective design, unclear clinical significance of imatinib trough concentrations, and the need for prospective validation. Practice relevance is limited: extending adjuvant therapy beyond 3 years is not routinely recommended at present. Causality should be interpreted cautiously; treatment duration was not significantly associated with survival benefit in multivariate analysis.

Many patients with high-risk gastrointestinal stromal tumors (GIST) wonder if taking their medication longer helps. This study looked at 75 patients who had surgery and then took Imatinib for either more than three years or three years or less. The goal was to see if the longer treatment time made a difference in stopping the cancer from coming back.

After five years, those who took the drug longer had slightly better relapse-free survival rates compared to the shorter group. However, when researchers adjusted for other factors, the extra time on medication did not significantly improve survival outcomes. Overall survival rates were the same for both groups.

The study also checked drug levels in the blood but found the meaning of those numbers is still unclear. Because this was a look back at past records, the results need to be checked in new, forward-looking studies before changing how doctors treat patients today.

What this means for you:

Taking Imatinib longer than three years did not significantly improve survival for high-risk GIST patients.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

BackgroundImatinib mesylate (IM) has changed the management of gastrointestinal stromal tumors (GISTs), especially for adjuvant therapy after radical resection. However, the optimal duration of the adjuvant therapy remains controversial. Therefore, this study evaluated the effect of adjuvant IM duration and plasma drug concentrations on survival outcomes of patients at high risk with GISTs.MethodsWe retrospectively analyzed patients diagnosed with high-risk GIST who underwent radical surgery at the First Affiliated Hospital of Chongqing Medical University between January 2008 and December 2021. Survival outcomes were compared according to adjuvant IM duration (≤3 years vs. >3 years). Plasma trough concentrations (Cmin) of IM were measured in a subset of patients and analyzed in relation to prognosis.ResultsThis study included 75 patients (42 males and 33 females), with a median age of 53 (24–79) years. Tumors were most commonly located in the small intestine (44 patients, 58.7%) and stomach (23 patients, 30.7%). Kaplan-Meier curve analysis showed that the 5-year relapse-free survival (RFS) rates were 84% and 74% in the groups with treatment duration >3 years and ≤3 years, respectively (P < 0.05), whereas no significant difference in 5-year overall survival (OS) was observed between the two groups (P > 0.05). In the multivariate analysis, treatment duration was not significantly associated with survival benefit (HR = 0.53, 95% CI 0.15–1.83, P = 0.313).ConclusionBased on this retrospective study, adjuvant IM for more than 3 years did not independently improve prognosis in patients with high-risk GIST following radical resection. Moreover, the clinical significance of IM Cmin remains unclear. Therefore, extending adjuvant therapy beyond 3 years is not routinely recommended at present. These findings require further validation through prospective studies.

Adjuvant Imatinib Beyond 3 Years in High-Risk GIST: 5-Year Relapse-Free Survival OutcomesExtending Imatinib beyond 3 years did not improve survival for high-risk GIST patients

Study Details

Experimental agents show response rates up to 70% in relapsed or refractory diffuse large B-cell lymphoma

New cancer therapies double response rates for tough lymphoma

Clinical research that matters. Delivered to your inbox.

Adjuvant Imatinib Beyond 3 Years in High-Risk GIST: 5-Year Relapse-Free Survival OutcomesExtending Imatinib beyond 3 years did not improve survival for high-risk GIST patients

More on gastrointestinal stromal tumor

Study Details

Experimental agents show response rates up to 70% in relapsed or refractory diffuse large B-cell lymphoma

New cancer therapies double response rates for tough lymphoma

Clinical research that matters. Delivered to your inbox.

Related in Oncology

From Other Specialties