Long-term outcome of S-1 and cisplatin combination therapy in patients with advanced or recurrent gastric cancer

Abstract

chemotherapy regimens using biochemical modulation and/or combination therapies have improved the prognosis of patients with gastric cancer. S-1 is an oral anticancer agent that was developed based on the theory of the biochemical modulation of 5-FU. S-1 is composed of tegafur (FT, a prodrug of 5-FU), 5-chloro-2,4-dihydroxypyridine (CDHP), and potassium oxonate (Oxo), at a molar ratio of 1 : 0.4 : 1 [1]. CDHP inhibits the biodegradation of 5-FU, and Oxo reduces 5-FUinduced gastrointestinal toxicities. In summary, S-1 not only increases the anticancer activity but also reduces the adverse reactions of 5-FU. In clinical studies, as a single agent, S-1 has demonstrated a higher response rate against gastric cancer compared to any other anticancer agent [2][3][4]. S-1 has become one of the drugs used in first-line chemotherapy for advanced or recurrent gastric cancer in Japan.In an attempt to increase the efficacy of S-1, several combination chemotherapy regimens using S-1 have been examined, and cisplatin (CDDP) has received attention as a result of its remarkable activity. Koizumi et al.[5] performed a phase I/II study of S-1 plus CDDP for patients with advanced gastric cancer. S-1 was administered at a standard dose for 3 weeks, and the recommended dose of CDDP, infused on day 8, was 60 mg/ m 2 ; this study revealed an overall response rate of 74%. Baba et al. [6] treated 12 patients using the same schedule, and showed a response rate of 66.7%. These results suggested the excellent therapeutic efficacy of the combination of S-1 and CDDP in the treatment of gastric cancer. However, the effect of the combination therapy on survival has been unclear.The aim of the present study was to evaluate the long-term outcome of combination therapy of CDDP and S-1. We compared, retrospectively, the clinical results of treatment with S-1 alone and treatment with S-1 plus CDDP in patients with advanced or recurrent gastric cancer who were treated in our hospital. AbstractBackground. Although combination therapy of S-1 and cisplatin (CDDP) has excellent efficacy against gastric cancer, the effect of the treatment on survival has been unclear. The aim of this study was to evaluate the long-term outcome of this combination therapy. Methods. Sixty-three patients with advanced or recurrent gastric cancer were treated with S-1, with or without CDDP, as first-line chemotherapy, and the clinical results were compared retrospectively. S-1 was administered orally at a standard dose of 80 mg/m 2 . In the treatment of the S-1 group, S-1 was given for 28 consecutive days, followed by a 14-day rest. In the treatment of the S-1/CDDP group, S-1 was given for 21 consecutive days, followed by a 14-day rest, and CDDP, at 60 mg/m 2 , was infused on day 8. Results. The incidence of adverse reactions of more than grade 3 was 22.5% in the S-1 group and 43.5% in the S-1/ CDDP group, and the treatment compliance was better in the S-1 group. The overall response rate was 25.9% in the S-1 group, and 36.8% in the S-1/CDDP group. The combination of S-1 with...

A Complete Response in Small Cell Carcinoma of the Esophagus Treated by S-1/Cisplatin Combined Chemotherapy and Radiotherapy

“…S-1 has been approved in Japan for gastric, colorectal, head and neck, breast, pancreas, biliary tract, and lung cancer. In particular, S-1/cisplatin combined therapy has a high response rate (37-74%) for gastric cancer [26,27]. Cho et al [28] reported the efficacy of S-1/ cisplatin therapy for advanced esophageal cancer, and the response rate was 74.1% (20 out of 27 cases), including a pathological complete response rate of 18.5% in primary lesions.…”

Gastric Small Cell Carcinoma Successfully Treated by Surgery and Postoperative Chemotherapy Consisting of Cisplatin and S-1: Report of a Case

“…In recent reports, this combination has been described to contribute to the long-term survival of these patients. 10,11 For these reasons, we selected S-1 in combination with CDDP for the present patient.…”

Phase II Study of S-1 Monotherapy as a First-line, Combination Therapy of S-1 plus Cisplatin as a Second-line, and Weekly Paclitaxel Monotherapy as a Third-line Therapy in Patients with Advanced Gastric Carcinoma

“…However, MST was 319 days and 322 days, respectively, which indicates that the therapies did not contribute in any way to the extension of survival time (18). Therefore, when chemotherapy is started with S-1 alone and it is found to be ineffective, it is expected that adding CDDP to the therapy does not shorten the survival time but, instead, it maintains the response rate with less incidence of sideeffects.…”