S-1-based<i>vs</i>non-S-1-based chemotherapy in advanced gastric cancer: A meta-analysis

Yang, Jian; Zhou, Yan; Min, Ke; Yao, Qiang; Xu, Chuanliang

doi:10.3748/wjg.v20.i33.11886

Cited by 24 publications

(35 citation statements)

References 37 publications

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“…The data in the current study do not therefore suggest any relevant change to the established safety profile of S-1, with no new safety concerns apparent for the EOS combination. Highlighting the potential of S-1 in this setting, a recent meta-analysis which compared S-1 based with non-S-1-based chemotherapy in the first-line Phase I study of orally administered S-1 in combination with epirubicin and oxaliplatin in… 365 treatment of advanced gastric cancer showed that S-1-based regimens were associated with higher objective response rates, longer overall survival, longer time-totreatment failure, and lower risks of febrile neutropenia and stomatitis [31]. In summary, the encouraging activity of the EOS regimen observed in this study, along with an acceptable safety profile, supports further clinical development of this combination.…”

Section: Discussionmentioning

confidence: 99%

Phase I study of orally administered S-1 in combination with epirubicin and oxaliplatin in patients with advanced solid tumors and chemotherapy-naïve advanced or metastatic esophagogastric cancer

et al. 2016

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Background This phase I study investigated the safety and the maximum tolerated dose (MTD) of the oral fluoropyrimidine S-1 when combined with epirubicin and oxaliplatin (EOS). Methods Patients aged C18 years with advanced or metastatic solid tumors were enrolled in a 3 ? 3 design with S-1 dose escalation (two planned cohorts) performed according to the occurrence of dose-limiting toxicity (DLT). On day 1 of each 21-day cycle, patients received epirubicin 50 mg/m 2 followed by oxaliplatin 130 mg/m 2 (maximum 8 cycles) and then S-1 [20 mg/m 2 (cohort 1) or 25 mg/m 2 (cohort 2), twice daily]: first dose, evening of day 1; subsequent administration on days 2-14, twice daily; last dose, morning of day 15 (unlimited number of S-1 cycles). After protocol amendment, enrollment in a third cohort was restricted to patients with chemotherapynaïve advanced or metastatic esophagogastric cancer. Results DLT was reported for two of the five patients in cohort 2, defining 20 mg/m 2 twice daily as the MTD of S-1 combined with epirubicin and oxaliplatin in heavily pretreated patients. Thirteen patients with chemotherapy-naïve advanced or metastatic esophagogastric cancer were subsequently enrolled and treated at an S-1 dose level of 25 mg/m 2 twice daily; no DLTs were reported; median overall survival was 13.1 months. Of the 11 evaluable patients, three (27 %) had partial responses and seven (64 %) had stable disease. The safety profile was in line with expectations. Conclusions The promising activity of EOS (S-1 dose level, 25 mg/m 2 twice daily) and acceptable safety profile support further clinical development of this combination for the first-line treatment of patients with advanced or metastatic esophagogastric cancer.

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Section: Discussionmentioning

confidence: 99%

Phase I study of orally administered S-1 in combination with epirubicin and oxaliplatin in patients with advanced solid tumors and chemotherapy-naïve advanced or metastatic esophagogastric cancer

et al. 2016

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“…Six meta-analyses compared S-1-based therapy with 5-FU-based therapy [7, 14, 19, 21, 24, 42]. Five of them compared OS [7, 14, 19, 24, 42].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Five of them compared OS [7, 14, 19, 24, 42]. Among them, four of them favored S-1-based therapy [14, 19, 24, 42] while one meta-analysis showed that there was no statistically difference between two groups in terms of OS [7]. As for objective RR or overall RR, three of them favored S-1 in terms of objective RR [7, 14, 24] while the other three meta-analyses suggested that overall RR was statistically similar between the two groups [19, 21, 42].…”

Section: Resultsmentioning

confidence: 99%

“…As for objective RR or overall RR, three of them favored S-1 in terms of objective RR [7, 14, 24] while the other three meta-analyses suggested that overall RR was statistically similar between the two groups [19, 21, 42]. Four meta-analyses reported PFS [7, 14, 21, 24,]. Two of them showed that the PFS was statistically similar between the S-1-based and 5-FU-based therapy [7, 24]; one favored S-1-based therapy over 5-FU-based therapy [14]; the other one revealed that S-1-based therapy was favorable in terms of median PFS but the 6-month PFS was statistically similar between two groups [21].…”

Section: Resultsmentioning

confidence: 99%

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Management of advanced gastric cancer: An overview of major findings from meta-analysis

Liu

Wang

et al. 2016

Oncotarget

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This study aims to provide an overview of different treatment for advanced gastric cancer. In the present study, we systematically reviewed the major findings from relevant meta-analyses. A total of 54 relevant papers were searched via the PubMed, Web of Science, and Google scholar databases. They were classified according to the mainstay treatment modalities such as surgery, chemotherapy and others. Primary outcomes including overall survival, response rate, disease-free survival, recurrence-free survival, progression-free survival, time-to-progression, time-to failure, recurrence and safety were summarized. The recommendations and uncertainties regarding the treatment of advanced gastric cancer were also proposed. It was suggested that laparoscopic gastrectomy was a safe and technical alternative to open gastrectomy. Besides, neoadjuvant chemotherapy and adjuvant chemotherapy were thought to benefit the survival over surgery alone. And it was demonstrated in the study that targeted therapy like anti-angiogenic and anti-HER2 agents but anti-EGFR agent might have a significant survival benefit.

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Comparing cytotoxic backbones for first‐line trastuzumab‐containing regimens in human epidermal growth factor receptor 2‐positive advanced oesophagogastric cancer: A meta‐analysis

Veer

Creemers

Waal

et al. 2018

Intl Journal of Cancer

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According to the Trastuzumab for Gastric Cancer (ToGA) study, trastuzumab plus cisplatin and capecitabine/5-fluorouracil (5-FU) is standard first-line treatment for human epidermal growth factor receptor 2 (HER2)-positive advanced oesophagogastric cancer. We examined the relative efficacy and safety of alternative trastuzumab-based cytotoxic backbone regimens compared to the standard ToGA regimen using meta-analysis. We searched Medline, EMBASE, CENTRAL and ASCO and ESMO up to March 2017 for studies investigating alternative first-line trastuzumab-based regimens for HER2-positive oesophagogastric cancer, defined as high protein expression IHC3+ or IHC2+ and gene amplification by in situ hybridisation. We compared primary outcome overall survival (OS) of alternative trastuzumab-based regimens to the ToGA regimen. Hazard ratios (HRs) and 95% confidence intervals (95%CI) were calculated by extraction of the published Kaplan-Meier curves. Incidence counts and toxicity sample-sizes were extracted for adverse events and compared using single-arm proportion meta-analysis in R. Fifteen studies (N = 557 patients) were included. OS was significantly longer with regimen trastuzumab plus doublet oxaliplatin and capecitabine/5-FU (median OS = 20.7 months) versus ToGA (16.0 months, HR = 0.75, 95% CI = 0.59-0.99) and was less toxic. Trastuzumab plus doublet cisplatin and S-1 showed no OS difference versus ToGA, but showed a different toxicity profile, including less hand-foot syndrome. Trastuzumab plus cisplatin or capecitabine as singlet backbone showed significantly worse survival and more toxicity versus ToGA regimen. Trastuzumab with triplet cytotoxic backbones or with bevacizumab and doublet cytotoxic backbone showed no survival benefit and more toxicity. In conclusion, trastuzumab plus doublet cytotoxic backbone containing oxaliplatin is preferable over the ToGA regimen with cisplatin. S-1 can substitute capecitabine or 5-FU when specific toxicities are encountered.

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S-1-basedvsnon-S-1-based chemotherapy in advanced gastric cancer: A meta-analysis

Abstract: S-1-based chemotherapy may be a good choice for AGC because of longer survival times, better tolerance and more convenient use.

Cited by 24 publications

References 37 publications

Phase I study of orally administered S-1 in combination with epirubicin and oxaliplatin in patients with advanced solid tumors and chemotherapy-naïve advanced or metastatic esophagogastric cancer

Phase I study of orally administered S-1 in combination with epirubicin and oxaliplatin in patients with advanced solid tumors and chemotherapy-naïve advanced or metastatic esophagogastric cancer

Management of advanced gastric cancer: An overview of major findings from meta-analysis

Comparing cytotoxic backbones for first‐line trastuzumab‐containing regimens in human epidermal growth factor receptor 2‐positive advanced oesophagogastric cancer: A meta‐analysis

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