Researchers conducted an exploratory qualitative study to understand how patients with oligometastatic gastrointestinal stromal tumors (GISTs) subjectively experienced the discontinuation of imatinib treatment when clinically indicated, as published in Anticancer Research.
Patients with metastatic GISTs usually receive lifelong imatinib treatment, but some studies have demonstrated that imatinib and other tyrosine kinase inhibitors are unsuccessful in completely eradicating metastatic GIST. Hence, a new treatment strategy has been proposed, in which imatinib is discontinued in patients who have received long-term imatinib treatment and have undergone resection of oligometastatic disease.
“Stopping a medication believed to keep GIST in remission could prove to be mentally challenging for trial participants,” Fauske and colleagues wrote. They hence decided to explore the changes to the quality of life of patients with oligometastatic GIST who have undergone discontinuation of imatinib treatment.
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The research team conducted interviews with a group of participants (n=9) regarding their experience during diagnosis, their life as a metastatic cancer patient on imatinib, and their experience after imatinib has been discontinued. The participants were informed that their answers would not affect their treatment and that they were free to withdraw from the study whenever they wanted.
The researchers carefully analyzed the answers given to ensure that no meaning has been altered because of mistranslation or misinterpretation. The interviews demonstrated that participants initially reported on how the side effects of imatinib had a negative impact on their quality of life.
“Once the side-effects had subsided or disappeared following discontinuation of imatinib, they reported having a surplus of energy, enjoying improved mental health and experiencing less challenges in daily life,” Fauske et al said. However, among the 9 participants, 5 experienced GIST relapses, but they were optimistic for a second remission upon restarting imatinib.
The insights gleaned from this study highlight the importance of qualitative assessments to better understand the patient experience during and after treatment. The research team believed that this approach can in turn translate to improved clinical practice.
Fauske L, Wærstad PH, Hompland I, Bruland ØS. Hope as a lifeline: imatinib discontinuation in patients with oligometastatic gastrointestinal stromal tumours. Anticancer Res. 2022;42(2):955-963. doi:10.21873/anticanres.15555