[Several patients with a metastasised gastrointestinal stroma-cell tumor for whom the tide turned by the introduction of imatinib].

The introduction of imatinib for gastrointestinal stroma-cell tumours (GISTs) reversed the chances of 3 cancer patients who had given up hope. One 40-year-old man with multiple chemotherapy-resistant GIST responded well to imatinib treatment in a phase-I setting. Another patient, a woman aged 77 years, was initially considered too old for chemotherapy, but was later accepted for treatment in an imatinib phase-III trial due to the positive results in other patients. The last patient, a woman aged 48 years, also responded to treatment with imatinib despite a massive tumour load and a WHO performance status of 3. She was almost free of complaints within a period of just a few weeks. Until recently, the prognosis for metastatic or irresectable GIST was almost certain death within 1 year after diagnosis. The recent registration of imatinib has dramatically changed the prognosis of this disease. These case reports also demonstrate that some patients in phase-I studies can actually benefit from participation in such trials. Furthermore, treating GIST patients in a poor condition with imatinib is justified by the high response rates and mild toxicity.