title: Results of a phase II trial of S-1 as first-line treatment of metastatic pancreatic cancer (CESAR-study group).
abstract: OBJECTIVE
  S-1, an oral fluoropyrimidine derivative, has previously demonstrated anticancer efficacy in pancreatic cancer (PC), predominantly in Asian populations. This study evaluated the antitumor effect and safety of S-1 in Caucasian patients with metastatic PC.
  
  
  METHODS
  Chemotherapy-naïve patients received S-1 orally at 30 mg/m(2) twice daily (BID) for 2 weeks, repeated every 3 weeks. Primary endpoint was ORR. Secondary endpoints included PFS, OS and safety assessment. The trial had a Simon's two-stage design with 22 patients evaluable for efficacy in stage 1 and an additional 18 patients in stage 2, if ≥3/22 patients had a confirmed response at the first stage.
  
  
  RESULTS
  Three out of 27 patients showed PR, however, detection of asymptomatic brain metastases in one of them prevented this study from proceeding to stage 2. The median PFS and OS for all patients was 3.5 and 9.1 months, respectively. The median duration of disease control for patients with SD or PR (n = 17) was 4.3 months. S-1 was well tolerated; fatigue was the most frequent grade 3/4 adverse event.
  
  
  CONCLUSIONS
  Efficacy data of PFS and OS are at least comparable to gemcitabine, the current standard of care. S-1 is active in Caucasian patients with metastatic PC.
authors.affiliation: Department of Haematology and Medical Oncology, University of Bochum (Marienhospital Herne), Herne, Germany. beate.schultheis@marienhospital-herne.de
authors.forename: Beate
authors.initials: B
authors.lastname: Schultheis
authors.forename: Dirk
authors.initials: D
authors.lastname: Strumberg
authors.forename: Lothar
authors.initials: L
authors.lastname: Bergmann
authors.forename: Ullrich
authors.initials: U
authors.lastname: Graeven
authors.forename: Axel-Rainer
authors.initials: AR
authors.lastname: Hanauske
authors.forename: Rainer
authors.initials: R
authors.lastname: Lipp
authors.forename: Jochen
authors.initials: J
authors.lastname: Schuette
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: Paul
authors.initials: P
authors.lastname: Scigalla
authors.forename: Max E
authors.initials: ME
authors.lastname: Scheulen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008198:Lymph Nodes; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid