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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 8/2020

01-08-2020 | Leukopenia | Original Article

A meta-analysis of efficacy and safety of S-1 monotherapy or combination therapy as first-line treatment in metastatic colorectal cancer

Authors: Zhan Wang, Miao-Miao Wang, Wen-Li Zhou, Chen-Yang Ye, Wei-Ping Dai, Xin-Ling Liu, Gui-Min Zhang, Guo-Liang Cheng, Yuan-Sheng Zang

Published in: International Journal of Colorectal Disease | Issue 8/2020

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Abstract

Purpose

To compare the efficacy and safety profile of S-1-based versus non-S-1-based chemotherapy as first-line treatment in mCRC.

Methods

Relevant randomized controlled trials (RCTs) were obtained from PubMed, Embase, and Ovid databases and the Cochrane library from database set up in May 2018. The RCTs of S-1-based monotherapy or combination therapy as first-line treatment were selected. The impact of S-1-based chemotherapy on progression-free survival (PFS) and overall survival (OS) was assessed by pooling data via RevMan 5.3.

Results

Meta-analysis of 10 RCTs showed that S-1-based chemotherapy significantly improved PFS (HR 0.90, 95% CI 0.84–0.97, P = 0.006). In subgroup analysis, there was a statistically significant increase in PFS when S-1-based chemotherapy was compared with 5-FU-based (HR 0.92, 95% CI 0.84–1.00, P = 0.04) or capecitabine-based chemotherapy (HR 0.85, 95% CI 0.73–0.99, P = 0.04). The meta-analysis of OS (HR 0.95, 95% CI 0.86–1.05, P = 0.36), overall response rate (ORR) (HR 0.99, 95% CI 0.84–1.17, P = 0.90), and disease control rate (DCR) (HR 1.61, 95% CI 0.87–3.00, P = 0.13) showed no statistical significance between S-1-based and non-S-1-based chemotherapy. The statistically significant differences in the meta-analysis indicated less incidence of graded 3–4 leucopenia (OR = 0.30, 95% CI 0.13–0.71, P = 0.006) and hand–foot syndrome (HFS) (OR = 0.24, 95% CI 0.10–0.58, P = 0.001) in the S-1-based chemotherapy, and there was no statistically significant difference for other adverse events.

Conclusions

S-1-based chemotherapy in mono or combined therapy was an attractive alternative to standard first-line regimen for patients of mCRC.
Appendix
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Metadata
Title
A meta-analysis of efficacy and safety of S-1 monotherapy or combination therapy as first-line treatment in metastatic colorectal cancer
Authors
Zhan Wang
Miao-Miao Wang
Wen-Li Zhou
Chen-Yang Ye
Wei-Ping Dai
Xin-Ling Liu
Gui-Min Zhang
Guo-Liang Cheng
Yuan-Sheng Zang
Publication date
01-08-2020
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 8/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-020-03606-x

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