Xu Tao, Xie Jianming, Jiang Chenrui, Zhu Suyan, Yan Zhilong, Xu Hongbin
Department of Pharmacy, the First Affiliated Hospital of Ningbo University, Zhejiang, China.
Department of Gastrointestinal Surgery, the First Affiliated Hospital of Ningbo University, Zhejiang, China.
Br J Cancer. 2025 Sep 4. doi: 10.1038/s41416-025-03173-4.
Adherence to imatinib may be even more limited in the adjuvant setting, as patients receiving adjuvant imatinib often do not experience disease symptoms after tumor removal. This real-world study aimed to gain insight into adherence to imatinib and the effect of adherence on treatment outcomes.
Postoperative GIST patients who visited the speciality clinic between January 2021 and September 2024 were included in the study.
Out of 143 patients, 45 were non-adherent. The restricted mean survival time (RMST) at 3 years was measured for progression-free survival (PFS). Non-adherent patients had an RMST of 24.65 months, whereas adherent patients had an RMST of 32.66 months (P < 0.05). In addition, the plasma trough concentration of imatinib (C) was lower in non-adherent patients than in adherent patients (737.68 vs. 1404.45 ng/mL, P < 0.05). Using therapeutic drug monitoring (TDM) as an objective measurement to assess adherence, C of 1211.50 ng/mL could be the optimal cutoff value to predict the risk of non-adherence.
Poor adherence to imatinib was a notable problem in postoperative adjuvant treatment and appeared to be associated with shorter PFS. Monitoring trough levels gives physicians an objective measurement to assess individual adherence and can support treatment decisions.
在辅助治疗中，患者对伊马替尼的依从性可能更有限，因为接受辅助性伊马替尼治疗的患者在肿瘤切除后通常没有疾病症状。这项真实世界研究旨在深入了解伊马替尼的依从性以及依从性对治疗结果的影响。
纳入2021年1月至2024年9月期间到专科门诊就诊的术后胃肠间质瘤患者。
143例患者中，45例不依从。测量了无进展生存期（PFS）3年时的受限平均生存时间（RMST）。不依从患者的RMST为24.65个月，而依从患者的RMST为32.66个月（P<0.05）。此外，不依从患者的伊马替尼血浆谷浓度（C）低于依从患者（737.68对1404.45 ng/mL，P<0.05）。使用治疗药物监测（TDM）作为评估依从性的客观指标，C为1211.50 ng/mL可能是预测不依从风险的最佳临界值。
伊马替尼依从性差是术后辅助治疗中的一个显著问题，似乎与较短的PFS相关。监测谷浓度为医生提供了一个评估个体依从性的客观指标，并可支持治疗决策。
