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Published on: April 3, 2026
Pathologic complete response with neoadjuvant imatinib for locally advanced pelvic GIST
Carla Rameri Alexandre Silva de Azevedo1, Tadeu Ferreira Paiva, Benedito Mauro Rossi
1Department of Oncology, Hospital A C Camargo, Rua Prof. Antônio Prudente, 211, Liberdade, São Paulo CEP 01509-900, Brazil. carla.rameri@bol.com.br
International Journal of Clinical Oncology
|October 6, 2010
Summary
This case study shows a complete pathologic response in a patient with advanced rectal gastrointestinal stromal tumor (GIST) treated with neoadjuvant imatinib. This approach enabled a conservative surgery and resulted in no evidence of disease post-treatment.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms.
- Complete pathologic response (pCR) to imatinib in GISTs is infrequently documented.
- Locally advanced, high-risk GISTs often require extensive surgical resection.
Observation:
- A 48-year-old male presented with a large (10 cm) pelvic GIST of rectal origin.
- Initial assessment suggested resectability but necessitated a highly invasive procedure.
- Neoadjuvant imatinib treatment was initiated, leading to a partial response and stable disease for over 15 months.
Findings:
- The patient underwent a conservative radical prostatectomy with anal sphincter preservation.
- Post-surgical pathological examination revealed no viable neoplastic cells, indicating a pCR.
- The patient remained disease-free at 15-month follow-up after a 6-month imatinib holiday.
Implications:
- Neoadjuvant imatinib may be a viable strategy for achieving pCR in large, unresectable pelvic or rectal GISTs.
- This approach can potentially facilitate less invasive surgical procedures.
- Further research into neoadjuvant imatinib for similar GIST presentations is warranted.