title: Phase II study of gemcitabine plus S-1 chemotherapy in recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-based chemotherapy.
abstract: OBJECTIVE
  No standard salvage regimen has been established for patients with recurrent and metastatic nasopharyngeal carcinoma (NPC) and disease progression after prior platinum-based chemotherapy. This phase II study was designed to evaluate the efficacy and safety of gemcitabine plus S-1 (GS) chemotherapy as a remedial regimen in this setting.
  
  
  METHODS
  In this multicenter phase II study, 49 patients with recurrent and metastatic NPC who failed previous platinum-based chemotherapy received gemcitabine (1.0 g/m(2) on days 1 and 8) plus oral S-1 chemotherapy (twice daily from day 1 to 14). Each cycle was repeated every 3 weeks for two cycles at least. The dose of S-1 was determined according to the body surface area (BSA): 40 mg twice a day for BSA <1.25 m(2); 50 mg twice a day for 1.25 m(2) ⩽ BSA <1.5 m(2); and 60 mg twice a day for BSA ⩾1.5 m(2).
  
  
  RESULTS
  Treatment was generally well-tolerated. A total of seven patients (14.3%) had grade 3 toxicities and the main toxicity was myelosuppression, whereas the nonhematology adverse events were minimal. There were 3 complete responses (6.4%), 17 partial responses (36.2%), and the overall response rate was 42.6% (95% confidence interval: 27.3-61.2). Median time to progression was 5.8 months and median survival was 14.8 months. The 1- and 2-year survival rates were 64% and 30%, respectively.
  
  
  CONCLUSIONS
  Gemcitabine plus S-1 offers a satisfactory clinical activity and an acceptable safety profile for recurrent and metastatic NPC patients after failure of platinum-based chemotherapy.
authors.affiliation: Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, People's Republic of China.
authors.forename: PeiJian
authors.initials: P
authors.lastname: Peng
authors.affiliation: Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, People's Republic of China.
authors.forename: XueQing
authors.initials: X
authors.lastname: Ou
authors.affiliation: Department of Medical Oncology, Cancer Center, Sun Yat-Sen University, Guangzhou, People's Republic of China.
authors.forename: Hai
authors.initials: H
authors.lastname: Liao
authors.affiliation: Department of Oncology, the People's Hospital of Zhongshan City, Zhongshan, People's Republic of China.
authors.forename: YuMeng
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, People's Republic of China.
authors.forename: SiYang
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, People's Republic of China.
authors.forename: ZhiBin
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, 52 Mei Hua Road East, Zhuhai 519000, Guangdong Province, People's Republic of China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Lin
keywords: S-1; gemcitabine; nasopharyngeal carcinoma; platinum