Safety, efficacy and pharmacokinetics of S-1 in a hemodialysis patient with advanced gastric cancer.
OBJECTIVE
The safety and efficacy of S-1 in hemodialysis patients have not been established. We evaluated the safety and efficacy and pharmacokinetics of S-1 in a hemodialysis patient with advanced gastric cancer.


METHODS
A 66-year-old Japanese man with chronic renal failure, who had undergone hemodialysis three times a week for 3 years. Based on the diagnosis of stage IV gastric cancer, S-1 therapy was started. S-1 was administered 11 times at a daily dose of 23.5 mg/m(2) (40 mg/body)after hemodialysis, followed by a rest. One course was a period of 28 days. Blood samples were obtained after the first administration of S-1 and before beginning the fourth course. The concentration of 5-FU was determined by high-performance liquid chromatography.


RESULTS
Area under the concentration-time curve (AUC)of 5-FU was 2647.2 ng h/mL after administration of S-1 of 23.5 mg/m(2) (40 mg/body). During the S-1 treatment,serious adverse events such as neutropenia were not observed; however, decreases in hemoglobin level were observed (grade 3). The treatment was well tolerated. After the second course of chemotherapy, the primary lesion showed a partial response and lymph node metastases and liver metastases showed stable disease.


CONCLUSIONS
Our results suggest that S-1 is an important treatment option for patients with hemodialysis with advanced gastric cancer.
Tomiyama
Nariaki
N
Department of Pharmacy, Izumi General Medical Center, 520, Myojin-cho, Izumi-shi, Kagoshima 899-0131, Japan. ntomiyama@po.synapse.ne.jp
Hidaka
Muneaki
M
Hidaka
Hideo
H
Kawano
Yukihiro
Y
Hanada
Norihisa
N
Kawaguchi
Hideki
H
Arimori
Kazuhiko
K
Nakamura
Chizuko
C
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000493:pharmacokinetics; D019540:Area Under Curve; D004338:Drug Combinations; D005472:Fluorouracil / Q000097:blood; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000493:pharmacokinetics*; D006435:Renal Dialysis; D013274:Stomach Neoplasms / Q000628:therapy*; D005641:Tegafur / Q000493:pharmacokinetics*; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D005472:Fluorouracil