{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:02:26Z","timestamp":1789783346682,"version":"4.0.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      To compare radiographic and pathology-integrated metrics for defining near-maximal treatment effect after neoadjuvant imatinib in\n                      <jats:italic toggle=\"yes\">KIT<\/jats:italic>\n                      exon 11-mutant gastrointestinal stromal tumor (GIST).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary of Background Data:<\/jats:title>\n                    <jats:p>Operative timing after neoadjuvant imatinib is usually guided by radiographic shrinkage, although dimensional response may incompletely reflect biological treatment effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 131 patients with locally advanced\n                      <jats:italic toggle=\"yes\">KIT<\/jats:italic>\n                      exon 11-mutant GIST treated with neoadjuvant imatinib followed by curative-intent resection at 2 tertiary sarcoma centers in the United States and Italy. Radiographic response was assessed across 2-month intervals using RECIST and percent tumor shrinkage. The primary timing analysis identified the earliest interval reaching 90% of peak median response within 3 to 22 months. The same framework was applied to a pathology-integrated response score (PIRS) derived from tumor shrinkage, viable tumor percentage, and necrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Median age was 62 years, and 60.3% of patients were male. By RECIST, 45.8% achieved partial response and 48.9% had stable disease. Radiographic response reached a near-maximal interval at &gt;4 to 6 months, whereas PIRS reached a near-maximal interval at &gt;10 to 12 months. PIRS discriminated across duration groups better than RECIST (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.027 vs.\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.13). Forty patients (30.5%) with stable disease had major or near-complete PIRS. Overall survival differed across PIRS categories, whereas recurrence-free survival did not differ across PIRS or RECIST categories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Radiographic and pathology-integrated response identified different windows of near-maximal treatment effect, suggesting that size reduction alone may underestimate biological response. The later pathology-integrated response window was not accompanied by differences in recurrence-free survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/sla.0000000000007141","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:00:34Z","timestamp":1782446434000},"page":"506-515","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Radiographic Versus Pathology-Integrated Response for Assessing Optimal Surgical Timing After Neoadjuvant Imatinib in Patients With Locally Advanced KIT Exon 11-Mutant GIST"],"prefix":"10.1097","volume":"284","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9404-7823","authenticated-orcid":false,"given":"Tannaz","family":"Ranjbarian","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego, CA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-6503","authenticated-orcid":false,"given":"Michela","family":"Del Simone","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sarcoma Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Jin Eastern","family":"Kang Sim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego, CA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Antkowiak","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego, CA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Sarno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego, CA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumei","family":"Kato","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"},{"name":"Department of Medicine, Division of Medical Oncology, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Burgoyne","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"},{"name":"Department of Medicine, Division of Medical Oncology, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena R.","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Callegaro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sarcoma Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Fanta","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"},{"name":"Department of Medicine, Division of Medical Oncology, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4703-3534","authenticated-orcid":false,"given":"Alessandro","family":"Gronchi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sarcoma Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4403-0271","authenticated-orcid":false,"given":"Jason K.","family":"Sicklick","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego, CA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA"},{"name":"Department of Pharmacology, University of California San Diego, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"R1-20260919","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.soc.2022.03.007","article-title":"Gastrointestinal stromal tumor: new insights for a multimodal approach","volume":"31","author":"Sharma","year":"2022","journal-title":"Surg Oncol Clin N Am"},{"key":"R2-20260919","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1245\/s10434-011-2190-5","article-title":"Phase II trial of neoadjuvant\/adjuvant imatinib mesylate for advanced primary and metastatic\/recurrent operable gastrointestinal stromal tumors: long-term follow-up results of Radiation Therapy Oncology Group 0132","volume":"19","author":"Wang","year":"2012","journal-title":"Ann Surg Oncol"},{"key":"R3-20260919","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1038\/bjc.2017.144","article-title":"Phase II study of neoadjuvant imatinib in large 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multicenter cohort study","volume":"24","author":"Zong","year":"2026","journal-title":"World J Surg Oncol"},{"key":"R13-20260919","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.ejso.2013.10.021","article-title":"Radiologic assessment of earliest, best, and plateau response of gastrointestinal stromal tumors to neoadjuvant imatinib prior to successful surgical resection","volume":"40","author":"Tirumani","year":"2014","journal-title":"Eur J Surg Oncol"},{"key":"R14-20260919","doi-asserted-by":"crossref","first-page":"424","DOI":"10.3390\/cancers11030424","article-title":"Prospective evaluation of neoadjuvant imatinib use in locally advanced gastrointestinal stromal tumors: emphasis on the optimal duration of neoadjuvant imatinib use, safety, and oncological outcome","volume":"11","author":"Wang","year":"2019","journal-title":"Cancers"},{"key":"R15-20260919","doi-asserted-by":"crossref","first-page":"e70237","DOI":"10.1002\/cam4.70237","article-title":"Safety, 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History"}},{"value":"2026-05-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}