A phase I/II study of fixed-dose-rate gemcitabine and S-1 with concurrent radiotherapy for locally advanced pancreatic cancer

Goji, Takahiro; Kimura, Tooru; Miyamoto, Hiroshi; Takehara, Masanori; Kagemoto, Kaizo; Okada, Yasuyuki; Okazaki, Jun; Takaoka, Yoshifumi; Miyamoto, Yukio; Mitsui, Yasuhiro; Matsumoto, Sayo; Sueuchi, T.; Tanaka, Kumiko; Fujino, Yuichi; Takaoka, T; Kitamura, Shinji; Okamoto, Koichi; Kimura, Masako; Sogabe, Masamichi; Muguruma, Naoki; Okahisa, Toshiya; Sato, Yasuhiro; Sagawa, Tamotsu; Fujikawa, Koji; Sato, Yasushi; Ikushima, Hitoshi; Takayama, Tetsuji

doi:10.1007/s00280-015-2835-3

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…Four clinical trials, two phase 3, one phase 2, and one phase 1/2, assessed gemcitabine and S-1, alone or in combination [2,9,10,11]. Uesaka et al [11] assessed gemcitabine or S-1 in patients with invasive ductal pancreatic carcinoma, stage I–III, with no local residual or microscopic residual tumor, and those with resected pancreatic cancer with no history of chemotherapy or radiotherapy within the past three years.…”

Section: Resultsmentioning

confidence: 99%

“…Median OS was 10.2 months in the gemcitabine plus S-1 group, 8.0 months in the S-1 only group, and 8.5 months in the gemcitabine only group. Goji et al [9] assessed fixed-dose rate gemcitabine and S-1 with a total radiation dose delivered concurrently in patients with unresectable pancreatic cancer confined to the pancreatic region with no prior treatment for pancreatic cancer. Median PFS was 11.0 months and median OS was 16.0 months (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Four trials [9,17,19,20] assessed combinations of chemotherapy and radiotherapy in patients with pancreatic cancer. Treatments and endpoint outcomes are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…S-1 was well tolerated in the adjuvant setting and could be administered with a higher relative dose-intensity than gemcitabine, even after pancreatectomy [11]. However, in non-adjuvant settings, S-1 alone [10,37] and its combinations, including, S-1 plus gemcitabine [10], S-1 plus oxaliplatin [32], S-1 plus leucovorin [36], and S-1 plus irinotecan [37], resulted in poor OS outcomes; in contrast, some studies found more promising results, such as the combination of S-1 with gemcitabine plus radiation [9] and S-1 plus paclitaxel [38]. The discrepancies in results may be because of differences in the study population in terms of progression of the disease.…”

Section: Discussionmentioning

confidence: 99%

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Chemotherapy in Pancreatic Cancer: A Systematic Review

et al. 2018

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Background and Aim: Pancreatic cancer is one of the most fatal cancers. Cytotoxic chemotherapy remains the mainstream treatment for unresectable pancreatic cancer. This systematic review evaluated and compared the overall survival (OS) and progression-free survival (PFS) outcomes obtained from recent phase 2 and 3 clinical trials of pancreatic cancer chemotherapy. Materials and methods: Thirty-two studies were included and compared based on chemotherapy agents or combinations used. Additionally, outcomes of first-line versus second-line chemotherapy in pancreatic cancer were compared. Results: In studies that investigated the treatments in adjuvant settings, the highest OS reported was for S-1 in patients, who received prior surgical resection (46.5 months). In neoadjuvant settings, the combination of gemcitabine, docetaxel, and capecitabine prior to the surgical resection had promising outcomes (OS of 32.5 months). In non-adjuvant settings, the highest OS reported was for the combination of temsirolimus plus bevacizumab (34.0 months). Amongst studies that investigated second-line treatment, the highest OS reported was for the combination of gemcitabine plus cisplatin (35.5 months), then temsirolimus plus bevacizumab (34.0 months). Conclusions: There is a need to develop further strategies besides chemotherapy to improve the outcomes in pancreatic cancer treatment. Future studies should consider surgical interventions, combination chemotherapy, and individualized second-line treatment based on the prior chemotherapy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Four trials [9,17,19,20] assessed combinations of chemotherapy and radiotherapy in patients with pancreatic cancer. Treatments and endpoint outcomes are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Chemotherapy in Pancreatic Cancer: A Systematic Review

et al. 2018

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“…Renal cell carcinoma (RCC) can form in the kidney, while malignant lymphoma develops in the lymph nodes in the abdominal cavity. In addition, pancreatic ductal adenocarcinoma (PDA) occurs in the pancreas, and has a poor prognosis despite advances in treatment strategies, such as surgery, irradiation and chemotherapy (2)(3)(4). Furthermore, intraductal papillary mucinous neoplasm (IPMN) forms multiple cystic lesions in the pancreas (5), and may then result in intraductal papillary mucinous adenocarcinoma (6).…”

Section: Introductionmentioning

confidence: 99%

Comparison of DWIBS/T2 image fusion and PET/CT for the diagnosis of cancer in the abdominal cavity

Tomizawa

Shinozaki

Uchida

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Fusion images of diffusion-weighted whole-body imaging with background body signal suppression and T2-weighted image (DWIBS/T2) demonstrate a strong signal for malignancies, with a high contrast against the surrounding tissues, and enable anatomical analysis. In the present study, DWIBS/T2 was compared with 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) for diagnosing cancer in the abdomen. Patient records, including imaging results of examination conducted between November 2012 and May 2014, were analyzed retrospectively. In total, 10 men (age, 73.6±9.6 years) and 8 women (age, 68.9±7.1 years) were enrolled into the current study. Of the enrolled patients, 2 were diagnosed with hepatocellular carcinoma, 1 with cholangiocellular carcinoma, 1 with liver metastasis, 2 with pancreatic ductal adenocarcinoma, 1 with renal cell carcinoma and 1 with malignant lymphoma. Benign lesions were also analyzed, including adenomyomatosis of the gallbladder (5 patients), intraductal papillary mucinous neoplasm (4 patients) and right adrenal adenoma (1 case). All the patients with cancer showed positive results on DWIBS/T2 images. However, only 7 out of 8 patients were positive with PET/CT. One patient with right renal cellular carcinoma was positive with DWIBS/T2, but negative with PET/CT. All the patients with benign lesions were negative with DWIBS/T2 and PET/CT. In conclusion, DWIBS/T2 was more sensitive in diagnosing cancer of organs in the abdominal cavity compared with PET/CT. Furthermore, negative results with DWIBS/T2 and PET/CT were useful for the diagnosis of benign lesions, such as adenomyomatosis of the gallbladder and intraductal papillary mucinous neoplasm.

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A phase II trial of neoadjuvant chemoradiotherapy with intensity-modulated radiotherapy combined with gemcitabine and S-1 for borderline-resectable pancreatic cancer with arterial involvement

Nagakawa

Hosokawa

Nakayama

et al. 2017

Cancer Chemother Pharmacol

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A phase I/II study of fixed-dose-rate gemcitabine and S-1 with concurrent radiotherapy for locally advanced pancreatic cancer

Abstract: The combination of FDR-gem and S-1 with radiation is a feasible regimen that shows favorable antitumor activity with an acceptable safety profile in patients with LAPC.

Cited by 8 publications

References 18 publications

Chemotherapy in Pancreatic Cancer: A Systematic Review

Chemotherapy in Pancreatic Cancer: A Systematic Review

Comparison of DWIBS/T2 image fusion and PET/CT for the diagnosis of cancer in the abdominal cavity

A phase II trial of neoadjuvant chemoradiotherapy with intensity-modulated radiotherapy combined with gemcitabine and S-1 for borderline-resectable pancreatic cancer with arterial involvement

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