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Gastro-intestinal stromal tumours (GIST) - imatinib

Imatinib for gastrointestinal stromal tumours

Guidance type:  Technology appraisal
Date issued:  October 2004

We will consult on our review plans for this guidance in October 2007.

Reference:  TA86

Summary

NICE has made the following recommendations about the use of imatinib to treat gastro-intestinal stromal tumours.

Imatinib is recommended at a dose of 400 mg a day as the first choice of treatment for people who have a gastro-intestinal stromal tumour that is KIT-positive, and cannot be removed surgically or has spread to other parts of the body.

The treatment is given at first for 12 weeks. The patient’s healthcare team then assesses whether the treatment is working (if it is, doctors may say the tumour is ‘responding to treatment’). To do this, they use CT scans and other tests to look at the size of the tumour, and also take into account the patient’s symptoms.

If the treatment is not working after this time, it should be stopped. If the tumour responds to treatment with imatinib, the patient should be reassessed about every 12 weeks until no further benefit from treatment can be detected. When this happens, the treatment should be stopped.

The dose of 400 mg a day should not be increased if the disease starts to get worse, even if the tumour initially responded to treatment.

Treatment with imatinib should be overseen by a cancer specialist with experience in treating patients who have gastro-intestinal stromal tumours that cannot be removed or have spread elsewhere in the body.

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