S-1 combined with cisplatin versus cisplatin alone for the treatment of advanced gastric cancer

Wu, Di; Li, Xin; Tong, Jinxue; Sun, Lingyu; Zheng, Haixue; Gao, Changlu; Yang, Dongdong; Liu, Dongzhe; Zhang, Qifan

doi:10.1097/cad.0000000000000242

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…Of the 18 reports remaining for full-text reading, 3 studies were eligible to assess SC versus 5-Fu plus cisplatin, 1 study was eligible to assess SC versus cisplatin alone, 2 studies were eligible to assess SC versus S-1 combined with oxaliplatin or leucovorin, and 2 studies were eligible to assess SC versus S-1, cisplatin combined with other treatment (i.e., TSU68, leucovorin). Following the inclusion and exclusion criteria, 8 RCTs [8,11–17] consisting of 2699 AGC patients were selected and included in this meta-analysis. Detailed information about the flow chart of study selection process is reported in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

The clinical outcomes of S-1 plus cisplatin for patients with advanced gastric cancer

Yang

Wang

et al. 2018

Medicine

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Background:To evaluate the clinical outcomes of S-1 plus cisplatin (SC) for the treatment of patients with advanced gastric cancer (AGC).Methods:A systematic literature search was conducted by searching PubMed, the Cochrane Library, Embase, China Biology Medicine disc (CBMdisc), China National Knowledge Infrastructure (CNKI), and WanFang Database, for all year up to January 2017. Pooled analyses of overall survival (OS), progress-free survival rates, and adverse events were performed.Results:A total of 8 random controlled trails (RCTs) consisting of 2699 patients with AGC were selected and included in this meta-analysis. The results of our meta-analysis showed that AGC patients who treated with SC regimen receive a similar OS (HR = 1.01, 95%CI: 0.86–1.18, P = .928), PFS (HR = 0.89, 95%CI: 0.72–1.09, P = .263), and overall response rate (HR = 0.88, 95%CI: 0.70–1.11, P = .283). However, SC regimen may increase the risk of 1 to 2 grade (OR = 1.128, 95%CI: 1.075–1.184, P = .000) and 3 to 4 grade (OR = 1.24, 95%CI: 1.01–1.52, P = .039) adverse events.Conclusion:SC chemotherapy showed no difference in survival compared with 5-FU- and S-1-based other therapy, but has a higher rate of adverse events compared with other chemotherapy regimens.

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Section: Resultsmentioning

confidence: 99%

The clinical outcomes of S-1 plus cisplatin for patients with advanced gastric cancer

Yang

Wang

et al. 2018

Medicine

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“…Therefore, the demographic characteristics of included trials were generally comparable. Several studies might introduce potential heterogeneity owing to incompatible baseline features with other studies, such as recruiting elderly patients (>70 years old), 12,[29][30][31][32] containing esophageal, [13][14][15]29,31,[33][34][35][36] fake registration identifier, 37 nonmeasurable cases only, 38 and peritoneal metastasis only 39 (Table 1). The influence on pooled results by these studies was further detected in sensitivity analysis.…”

Section: General Analysis: Baseline Features and Transitivitymentioning

confidence: 99%

First-line systemic therapy for advanced gastric cancer: a systematic review and network meta-analysis

et al. 2019

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Background: Systemic therapy is the standard treatment against advanced gastric cancer. Fluoropyrimidine plus platinum doublet has been recommended as the preferred first-line strategy. However, there is still a lack of a comprehensive and hierarchical evidence that compares all eligible literature simultaneously. Methods: Record retrieval was conducted in PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, ASCO, and ESMO meeting library from inception to October 2018. Randomized controlled trials featuring comparisons between different first-line systemic treatments against advanced gastric cancer were eligible. Overall survival was utilized as the primary endpoint. Pairwise and network calculations were based on a random-effects model and the hierarchical ranking was numerically indicated by P-score. All procedures were conducted according to Cochrane Handbook 5.1 and PRISMA for Network Meta-analysis (Registration identifier: CRD42018084951). Results: A total of 119 studies were eligible for our pooled analysis. Concerning general analysis, ‘fluoropyrimidine plus platinum-based triplet’ topped the overall survival hierarchy (HR 0.91 [0.83–0.99], P-score = 0.903, p = 0.04) while it ranked in second place for progression-free survival and objective response rate. However, it displayed worse tolerability against ‘fluoropyrimidine plus platinum doublet’. More specifically, ‘Capecitabine plus cisplatin-based triplet plus targeted medication’ topped the ranking among all fluoropyrimidine plus platinum-based regimens in additional analysis. Nevertheless, it did not reach statistical advantage against fluoropyrimidine plus oxaliplatin doublet in terms of survival benefits, while still displaying significantly worse safety profile. Conclusions: Taken together, fluoropyrimidine plus oxaliplatin doublet (especially capecitabine or S-1) should still be considered as the preferred first-line regimen owing to its comparable survival benefits and lower toxicity.

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Chemotherapy for advanced gastric cancer

Wagner

Syn

Moehler

et al. 2017

Cochrane Database of Systematic Reviews

783

484

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Chemotherapy improves survival (by an additional 6.7 months) in comparison to BSC, and combination chemotherapy improves survival (by an additional month) compared to single-agent 5-FU. Testing all patients for HER-2 status may help to identify patients with HER-2-positive tumours, for whom, in the absence of contraindications, trastuzumab in combination with capecitabine or 5-FU in combination with cisplatin has been shown to be beneficial. For HER-2 negative people, all different two-and three-drug combinations including irinotecan, docetaxel, oxaliplatin or oral 5-FU prodrugs are valid treatment options for advanced gastric cancer, and consideration of the side effects of each regimen is essential in the treatment decision. Irinotecan-containing combinations and docetaxel-containing combinations (in which docetaxel was added to a single-agent or two-drug (platinum/5-FUcombination) show significant survival benefits in the comparisons studied above. Furthermore, docetaxel-containing three-drug regimens have increased response rates, but the advantages of the docetaxel-containing three-drug combinations (DCF, FLO-T) are counterbalanced by increased toxicity. Additionally, oxaliplatin-containing regimens demonstrated a benefit in OS as compared to the same regimen containing cisplatin, and there is a modest survival improvement of S-1 compared to 5-FU-containing regimens.Whether the survival benefit for three-drug combinations including cisplatin, 5-FU, and epirubicin as compared to the same regimen without epirubicin is still valid when second-line therapy is routinely administered and when cisplatin is replaced by oxaliplatin and 5-FU by capecitabine is questionable. Furthermore, the magnitude of the observed survival benefits for the three-drug regimens is not large enough to be clinically meaningful as defined recently by the American Society for Clinical Oncology (Ellis 2014). In contrast to the comparisons in which a survival benefit was observed by adding a third drug to a two-drug regimen at the cost of increased toxicity, the comparison of regimens in which another chemotherapy was replaced by irinotecan was associated with a survival benefit (of borderline statistical significance), but without increased toxicity. For this reason irinotecan/5-FU-containing combinations are an attractive option for first-line treatment. Although they need to be interpreted with caution, subgroup analyses of one study suggest that elderly people have a greater benefit form oxaliplatin, as compared to cisplatin-based regimens, and that people with locally advanced disease or younger than 65 years might benefit more from a three-drug regimen including 5-FU, docetaxel, and oxaliplatin as compared to a two-drug combination of 5-FU and oxaliplatin, a hypothesis that needs further confirmation. For people with good performance status, the benefit of second-line chemotherapy has been established in several RCTs.

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S-1 combined with cisplatin versus cisplatin alone for the treatment of advanced gastric cancer

Cited by 6 publications

References 23 publications

The clinical outcomes of S-1 plus cisplatin for patients with advanced gastric cancer

The clinical outcomes of S-1 plus cisplatin for patients with advanced gastric cancer

First-line systemic therapy for advanced gastric cancer: a systematic review and network meta-analysis

Chemotherapy for advanced gastric cancer

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