S-1 plus cisplatin versus fluorouracil plus cisplatin in advanced gastric or gastro-esophageal junction adenocarcinoma patients: a pilot study

Abstract

The safety and efficacy of S-1 plus cisplatin in Chinese advanced gastric cancer patients in first line setting is unknown. In this pilot study, patients with advanced gastric or gastro-esophageal junction adenocarcinoma were enrolled and randomly assigned in a 1:1 ratio to receive S-1 plus cisplatin (CS group) or 5-FU plus cisplatin (CF group). The primary endpoint was time to progression (TTP). Secondary end points included overall survival (OS) and safety. This study was registered on ClinicalTrials. Gov, number NCT01198392. A total of 236 patients were enrolled. Median TTP was 5.51 months in CS group compared with 4.62 months in CF group [hazard ratio (HR) 1.028, 95% confidential interval (CI) 0.758-1.394, p = 0.859]. Median OS was 10.00 months and 10.46 months in CS and CF groups (HR 1.046, 95%CI 0.709-1.543, p = 0.820), respectively. The most common adverse events in both groups were anemia, leukopenia, neutropenia, nausea, thrombocytopenia, vomiting, anorexia and diarrhea. We find that S-1 plus cisplatin is an effective and tolerable option for advanced gastric or gastro-esophageal junction adenocarcinoma patients in China.

Frequency and clinicopathological features of metastasis to liver, lung, bone, and brain from gastric cancer: A SEER‐based study

“…GC is still the second most common cause of cancer‐related death in developing countries 3, 4, 5, 6, 7, 8, 9, 10. The estimated new GC patients in United States in 2017 are 28 000 and estimated deaths are 10 960 11.…”

Comparative study of cisplatin-based definitive concurrent chemoradiotherapy with S-1 versus paclitaxel for unresectable locally advanced esophageal squamous cell carcinoma

“…Preclinical studies indicated that S-1 demonstrates far superior anti-tumor activities than 5-Fu and enhances the sensitivity of cancer cells to the effects of RT [10, 11]. Accumulating clinical evidence also supports the opinion that the combination of CDDP and S-1(CS) represents a viable treatment regimen for esophageal cancer [12, 13]. In studies performed in Japan, the CS regimen combined with RT in the setting of CCRT achieved encouraging response rates of 64.4%-–89.7%.…”

Future directions in esophageal cancer therapy

“…Two recent trials have indicated that S-1 is effective against esophageal carcinoma and well-tolerated. Currently, there are five ongoing clinical trials that are evaluating its efficacy in various stages of disease and various esophageal cancer patients (17,18). Notably, one of these studies (NCT02347904) will test the feasibility of administering 6 cycles of oxaliplatin and S-1 as adjuvant therapy starting 12 weeks after esophagectomy.…”