title: S-1 monotherapy as second-line treatment for advanced pancreatic cancer after gemcitabine failure.
abstract: OBJECTIVE
  No standard salvage chemotherapy regimen has been established for patients with advanced pancreatic cancer after failure of gemcitabine-based treatment. Although a Phase II study of S-1 monotherapy was conducted in patients with gemcitabine-refractory advanced pancreatic cancer, the number of patients enrolled was small.
  
  
  METHODS
  We retrospectively reviewed 84 consecutive patients who received S-1 monotherapy as a second-line treatment after gemcitabine failure at the Shizuoka Cancer Center between May 2004 and April 2008. The selection criteria in this study were age 20-75 years, ECOG performance status <or=2 and preserved organ functions. S-1 was administered orally twice a day at a dose of 40 mg/m(2) for 28 days, followed by 14-day rest.
  
  
  RESULTS
  Fifty-two patients were selected for the analysis. Out of the 47/52 patients with measurable lesions, only 2 patients (4%) showed a partial response and 15 patients (32%) showed stable disease. The median progression-free survival was 2.1 months and the median overall survival was 5.8 months, with a 1-year survival rate of 12%. The common grade 3/4 toxicities were diarrhea (8%), anorexia (6%), fatigue (6%), anemia (6%) and leucopenia (4%).
  
  
  CONCLUSIONS
  S-1 monotherapy is marginally effective and well tolerated in the second-line setting in patients with gemcitabine-refractory advanced pancreatic cancer.
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan. a.todaka@scchr.jp
authors.forename: Akiko
authors.initials: A
authors.lastname: Todaka
authors.forename: Akira
authors.initials: A
authors.lastname: Fukutomi
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hironaka
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Keisei
authors.initials: K
authors.lastname: Taku
authors.forename: Nozomu
authors.initials: N
authors.lastname: Machida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Hideharu
authors.initials: H
authors.lastname: Tomita
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D004338:Drug Combinations; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine