title: A Meta-analysis Reveals S-1-based Chemotherapy Improves the Survival of Patients With Advanced Gastric Cancer.
abstract: The aim of this study was to compare the efficacy and safety of S-1-based therapy versus non-S-1-based therapy in advanced gastric cancer (AGC) patients.Eligible studies stratifying objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) in AGC patients were identified from Embase, Pubmed, Cochrane Library, and China National Knowledge Infrastructure databases. The STATA package (version 11.0) was used to pool the data from the eligible studies.Fifteen studies with 2973 AGC cases, of which 1497 (50.4%) received S-1-based therapy and 1476 (49.6%) received non-S-1-based therapy, were identified in the meta-analysis. AGC patients who had received S-1-based therapy had a higher median OS, median PFS, and ORR than those who had received 5-fluorouracil (FU)-based therapy (OS: hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.80-0.98, P = 0.015; PFS: HR 0.88, 95% CI 0.80-0.98, P = 0.016; ORR: OR 1.25, 95% CI 1.08-1.45, P = 0.003, respectively). S-1-based therapy had similar efficacy to capecitabine-based therapy in terms of median OS (HR 1.14, 95% CI 0.91-1.41, P = 0.253), median PFS (HR 1.01, 95% CI 0.82-1.25, P = 0.927), and ORR (OR 0.84, 95% CI 0.63-1.12, P = 0.226). Subgroup analysis for grade 3 to 4 toxicity showed higher incidence of neutropenia (relative risk [RR] = 0.827, P = 0.006), nausea (RR = 0.808, P = 0.040), and lower diarrhea (RR = 1.716, P = 0.012) in 5-FU-based arm, and higher diarrhea (RR = 0.386, P = 0.007) in capecitabine-based arm.S-1-based chemotherapy is favorable to AGC patients with better clinical benefit than 5-FU-based chemotherapy and with equivalent antitumor compare with capecitabine-based therapy.
authors.affiliation: From the Hospital Quality Management Office (F-LW); Department of Endocrinology (D-CL, A-MZ, XY, JZ, H-QH); Department of Thoracic and Cardiovascular Surgery (Y-PY); Outpatient Department (J-JH, H-YZ); Department of Gastroenterology (D-KJ); and Department of Infectious Disease, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China (M-WC).
authors.forename: Fang-Lan
authors.initials: FL
authors.lastname: Wu
authors.forename: De-Cheng
authors.initials: DC
authors.lastname: Lu
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Ying
authors.forename: Jin-Jiao
authors.initials: JJ
authors.lastname: Huang
authors.forename: Ai-Min
authors.initials: AM
authors.lastname: Zhou
authors.forename: Dun-Ke
authors.initials: DK
authors.lastname: Jiang
authors.forename: Mao-Wei
authors.initials: MW
authors.lastname: Chen
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.forename: Jia
authors.initials: J
authors.lastname: Zhou
authors.forename: Hui-Qiao
authors.initials: HQ
authors.lastname: Huang
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Zeng
mesh_terms: D000069287:Capecitabine; D002681:China; D002986:Clinical Trials as Topic; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000069287:Capecitabine; D005472:Fluorouracil