A retrospective comparison of S-1 plus cisplatin and capecitabine plus cisplatin for patients with advanced or recurrent gastric cancer

• Published in: International journal of clinical oncology Vol. 18; no. 3; pp. 539 - 546
• Main Authors: Shitara, Kohei, Sawaki, Akira, Matsuo, Keitaro, Kondo, Chihiro, Takahari, Daisuke, Ura, Takashi, Tajika, Masahiro, Niwa, Yasumasa, Muro, Kei
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.06.2013; Springer Nature B.V
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cancer; Cancer Research; Capecitabine; Chemotherapy; Cisplatin - administration & dosage; Comparative studies; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Drug Combinations; Female; Fluorouracil - administration & dosage; Fluorouracil - analogs & derivatives; Gastrointestinal diseases; Humans; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Oncology; Original Article; Oxonic Acid - administration & dosage; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Surgical Oncology; Tegafur - administration & dosage; Chemotherapy; Capecitabine; Gastric cancer; S-1; Cisplatin
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-012-0416-6

Background Based on the results of the SPIRITS trial, combination chemotherapy of S-1 plus cisplatin (SP) is now considered the standard treatment for patients with advanced gastric cancer (AGC) in Japan. On the other hand, several non-Japanese studies have shown the efficacy of capecitabine plus cisplatin (XP), which has been used as the reference arm in recent global studies of AGC. Methods We retrospectively compared the efficacy and safety of SP and XP in first-line treatment for patients with AGC. Results From August 2006 to November 2008, 26 AGC patients received XP in the context of 2 global trials (AVAGAST and ToGA), and 50 patients received SP during the same period. The objective response rate was 43.2 % in the SP group and 50 % in the XP group, with no significant difference ( p  = 0.62). There were also no significant differences in progression-free survival (median 5.8 vs. 5.2 months; p  = 0.91) and overall survival (median 13.8 vs. 13.5 months; p  = 0.97) between the SP and XP groups. The frequencies of hematological toxicities of grade 3 or more and non-hematological toxicities were not significantly different between the 2 groups. Although grade 1 or 2 hand–foot syndrome was more common in the XP group, no patients experienced grade 3 or more. Conclusions Although the retrospective nature of this study and the small number of patients is a major limitation, SP and XP were associated with similar efficacy and safety in patients with AGC.