Does adjuvant Gleevec prevent recurrence?
This is unknown and the subject of the trials. The Z9001 trial was stopped early because it did show that, at a minimum, Gleevec at least dramatically delayed resistance (see Clinical trial confirms Gleevec reduces recurrence). It is well established that patients with measurable disease that stop taking Gleevec have a very high chance of progression. Gleevec does not kill all GIST tumor cells. Some residual cells remain alive after/during Gleevec treatment which become active again after Gleevec is stopped. The number of residual cells may vary greatly from patient to patient. Some may only have a small number of viable cells left and, for others, the vast majority may still be viable. Does adjuvant Gleevec promote resistance? This is unknown. For KIT exon 9 patients, the 400 mg dose being used in adjuvant treatment has been shown to be ineffective as a first-line treatment against measurable disease. For patients with measurable disease, Heinrich et al. showed that patients on high-d
