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

Rino, Yasushi; Yukawa, Norio; Wada, Nobuyuki; Suzuki, Makoto; Murakami, Hitoshi; Yamada, Takanobu; Nakayama, Hirotaka; Yamamoto, Naoto; Sato, Tsutomu; Yamada, Roppei; Ohshima, Takashi; Masuda, Munetaka; Imada, Toshio

doi:10.4137/cmo.s610

Cited by 3 publications

(3 citation statements)

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“…In Japan, Korea, and Italy, on the basis of the results of several studies on second-line chemotherapy [16][17][18][19][20], more than half of patients with AGC receive second-line treatment in clinical practice [21]. Taxanes and irinotecan are the most commonly used agents as second-line chemotherapy [16][17][18][19][20]22]. Recently, in a small randomized phase III study with 40 patients with AGC, best supportive care (BSC) plus second-line irinotecan improved overall survival (OS) over BSC alone [23].…”

Section: Introductionmentioning

confidence: 99%

Optimal indications for second-line chemotherapy in advanced gastric cancer

et al. 2012

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As it remains uncertain whether patients with advanced gastric cancer who progress after first-line chemotherapy should receive second-line chemotherapy, we attempted to identify the optimal indications for second-line chemotherapy. In this retrospective study, 101 patients were included in univariate and multivariate analyses to identify clinicopathological variables independently associated with longer survival postprogression (SPP), defined as the time from recognition of disease progression on first-line chemotherapy to death from any cause or last follow-up. The median SPP was 340 days. On multivariate analysis, performance status 2 [hazard ratio (HR), 14.234; 95% confidence interval (CI), 2.766-73.258], serum albumin level less than 3.5 g/dl (HR, 2.088; 95% CI, 1.047-4.060) at initiation of second-line chemotherapy, and time to progression less than 170 days on first-line chemotherapy (HR, 2.497; 95% CI, 1.227-5.083) were identified as independent prognostic factors associated with shorter SPP. The median SPP was 496, 375, and 232 days in patients with 0, 1, and 2 of these 3 negative prognostic factors, respectively (P=0.0002). The present study suggests that second-line chemotherapy would not be beneficial in patients with two or more of the following three negative prognostic factors: performance status 2, serum albumin less than 3.5 g/dl at initiation of second-line chemotherapy and time to progression less than 170 days on first-line chemotherapy.

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Section: Introductionmentioning

confidence: 99%

Optimal indications for second-line chemotherapy in advanced gastric cancer

et al. 2012

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“…Currently, neoadjuvant chemoradiotherapy (CRT) is widely used for the treatment of locally advanced gastric cancer to inhibit tumor growth, making it more amenable to resection, and to decrease the risk of tumor cell metastasis ( 10 – 13 ). Paclitaxel chemotherapy is an effective drug for advanced gastric cancer with acceptable toxic side-effects, and has been considered as an effective anticancer agent due to the smooth transition to the subsequent regimen ( 14 ). Carboplatin radiotherapy in combination with 2-(8-hydroxy-6-methoxy-1-oxo-1H-2-benzopyran-3-yl) propionic acid can inhibit gastric tumor growth, which may be an effective drug in the treatment of gastric cancer ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Regulatory T‑cell density and cytotoxic T lymphocyte density are associated with complete response to neoadjuvant paclitaxel and carboplatin chemoradiotherapy in gastric cancer

et al. 2018

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Regulatory T-cell density and cytotoxic T lymphocyte density are crucial in regulating antitumor immune responses. Tumor infiltration has marked therapeutic effects in gastric carcinoma, and there is evidence that chemoradiotherapy (CRT) exhibits an immune-mediated component. In the present study, the density of CD4+ and CD8+ cells were evaluated in post-CRT surgical samples from 68 patients with gastric cancer using immunohistochemistry. The associations between T-cell density, cytotoxic T lymphocyte density and clinical survival rate were also analyzed. Cytotoxic T lymphocyte density was associated with gastric carcinoma regression grade and regulatory T-cell density was also associated with gastric carcinoma regression grade. Of the patients who had a pathologic complete response, 84 and 76% were found to have a high CD3+ and CD4+ cell density, which was significantly different to patients who had a low CD3+ and CD4+ cell density. High cytotoxic T lymphocyte density was also associated with improved survival rates of patients with gastric cancer. In conclusion, these outcomes indicated that regulatory T-cell density and cytotoxic T lymphocyte density in the tumor microenvironment were associated with the response to neoadjuvant CRT and may represent a therapeutic target for gastric cancer.

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“…In our previous report, 5 we evaluated S-1, S-1 plus cisplatin, and paclitaxel as chemotherapeutic regimens for treatment of advanced gastric cancer by measuring the objective response rate (RR), overall survival, and the safety profile, for the use of these therapies as first, second, and third line chemotherapeutic regimens. In this previous report, MST was not calculated because more than half of the patients were alive.…”

Section: Introductionmentioning

confidence: 99%

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

Rino

Yukawa

Murakami

et al. 2010

Clin Med Insights Oncol

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Background:We have previousy reported on a 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 carcinomas. The median survival time (MST) of patients over the whole course of treatment was not previously calculated because 12 out of 19 patients had not yet succumbed. Since then, we have calculated the MST for this study and herein report our findings.Patients and Methods:Between 2002 and 2005, 19 patients were enrolled in this study. Chemotherapy consisted of either 60 mg/m2 of S-1 for 4 weeks at 6-week intervals, a combination of 60 mg/m2 S-1 for 3 weeks and 60 mg/m2 cisplatin on day 8 at 5-week intervals, or 60 mg/m2 paclitaxel at days 1, 8, and 15, at 4-week intervals. The regimens were repeated until the occurrence of unacceptable toxicities, disease progression, or patient noncompliance. The primary end point was the overall survival.Results:The median survival time was 774 days. The response rates were 33.3% (3/9), 12.5% (1/8), and 0% (0/4) after the first, second, and third line chemotherapies, respectively. The major adverse hematological toxicity was leukopenia, which reached grades 3–4 in all lines of chemotherapy investigated. In addition, the major adverse non-hematological toxicity was anorexia, which reached grade 3–4 in second line chemotherapy, and no deaths were attributable to the adverse effects of the drugs.Conclusion:This sequential therapy was an effective treatment for advanced gastric cancer with acceptable toxic side-effects. We considered this therapy to be effective because of the smooth transition to the next regimen.

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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

Abstract: Background: We conducted a pilot phase II study to evaluate the effi cacy and safety of S-1 as a fi rst-line, S-1 plus cisplatin as a second-line, and weekly paclitaxel as a third-line therapy for advanced gastric cancer.

Cited by 3 publications

References 20 publications

Optimal indications for second-line chemotherapy in advanced gastric cancer

Optimal indications for second-line chemotherapy in advanced gastric cancer

Regulatory T‑cell density and cytotoxic T lymphocyte density are associated with complete response to neoadjuvant paclitaxel and carboplatin chemoradiotherapy in gastric cancer

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

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