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In Reply

Dana-Farber Cancer Institute, Boston, MA

Michael C. Heinrich

Oregon Health and Sciences University Cancer Institute, Portland, OR

In Reply:

On behalf of the study team, we thank Drs Ray and Lawrence for their insightful comments on our recent article¹ discussing the intriguing activity seen with imatinib in patients with aggressive fibromatosis (desmoid tumors). We agree completely that radiotherapy can be useful in the management of patients with desmoid tumors as an effective therapy, and we never wished to imply otherwise. The Clinical Practice Guidelines of the National Comprehensive Cancer Network clearly state that radiotherapy is an effective option for many patients with desmoid tumors in instances where surgery is not feasible. However, it is also important to note that desmoid tumors can still represent an unmet medical need. We are recognizing an increasing incidence of intra-abdominal desmoid tumors in patients with polyposis syndromes, and these can be multifocal and clustered around the superior mesenteric artery, making effective radiotherapy challenging if not impossible. There are other clinical situations as well where radiotherapy or surgery would present less than optimal options as a result of anatomic or functional constraints. For such patients, development of new targeted therapies may be a promising area of future research. Our manuscript was only intended to highlight a new area of research for patients suffering from this disease and was not intended to present a comprehensive overview of other management options for these patients.

Authors' Disclosures of Potential Conflicts of Interest

Although all authors completed the disclosure declaration, the following authors or their immediate family members indicated a financial interest. No conflict exists for drugs or devices used in a study if they are not being evaluated as part of the investigation. For a detailed description of the disclosure categories, or for more information about ASCO’s conflict of interest policy, please refer to the Author Disclosure Declaration and the Disclosures of Potential Conflicts of Interest section in Information for Contributors.

Authors Employment Leadership Consultant Stock Honoraria Research Funds Testimony Other George D. Demetri Novartis (A) Novartis (C) Novartis (C) Michael C. Heinrich Novartis (A) Novartis (A) Novartis (C)

Dollar Amount Codes (A) < $10,000 (B) $10,000-99,999 (C) $100,000 (N/R) Not Required

REFERENCE

1. Heinrich MC, McArthur GA, Demetri GD, et al: Clinical and molecular studies of the effect of imatinib on advanced aggressive fibromatosis (desmoid tumor). J Clin Oncol 24:1195-1203, 2006[Abstract/Free Full Text]

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Related Correspondence

• Radiation Therapy for Aggressive Fibromatosis (desmoid tumor)
  Michael E. Ray and Theodore S. Lawrence
  JCO 2006 24: 3714-3715 [Full Text]

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