Irinotecan plus cisplatin therapy and S-1 plus cisplatin therapy for advanced or recurrent gastric cancer in a single institution.
BACKGROUND
From the results of the JCOG9912 and SPIRITS trials, S-1 plus cisplatin (CDDP) therapy (SP) has been recognized as the standard chemotherapy for advanced gastric cancer in Japan. However, in their subsets of patients with the target lesion, irinotecan (CPT-11) plus CDDP therapy (IP) resulted in longer survival than 5-fluorouracil alone while SP exhibited a survival similar to S-1 alone. The objective of this study was to clarify the safety and efficacy of these two regimens.


METHODS
Forty-four patients were treated with IP and 32 with SP between September 2002 and July 2006 at Shizuoka Cancer Center. In IP, 70 mg/m(2) CPT-11 was administered on Days 1 and 15, 80 mg/m(2) CDDP on Day 1, repeated every 4 weeks. In SP, 40-60 mg S-1 depending on the patient's body surface area was given orally twice daily for 21 days and 60 mg/m(2) CDDP intravenously on Day 8, repeated every 5 weeks.


RESULTS
The response rate, progression-free survival and median survival were 47% (17 of 36), 170 and 444 days in IP, and 80% (21 of 26), 235 and 469 days in SP. In patients with target lesions, those were 47%, 170 and 431 days in IP, and 80%, 235 and 442 days in SP. The incidence of Grade 3 or 4 toxicity was similar in both groups, but patient refusal of treatment was more frequent for IP than for SP.


CONCLUSIONS
Our results demonstrate a better efficacy and feasibility of SP than IP for advanced gastric cancer patients, with or without a target lesion.
Nakashima
Koji
K
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-Gun, Shizuoka, Japan.
Hironaka
Shuichi
S
Boku
Narikazu
N
Onozawa
Yusuke
Y
Fukutomi
Akira
A
Yamazaki
Kentaro
K
Yasui
Hirofumi
H
Taku
Keisei
K
Kojima
Takashi
T
Machida
Nozomu
N
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010094:Oxonic Acid / Q000008:administration & dosage; D019233:Retreatment; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016019:Survival Analysis; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin