More than 6 months of postoperative adjuvant chemotherapy results in loss of skeletal muscle: a challenge to the current standard of care

Excerpt

In Japan, patients with curatively resected stage II/III gastric cancer undergo postoperative adjuvant chemotherapy with single agent S-1 for 12 months as a standard of care. This treatment is not comfortable for everyone, however, and only 340 of 517 patients (65.8 %) who were randomized to receive the S-1 monotherapy were able to complete the 12-month treatment in the phase III trial that eventually generated the hard evidence for this strategy [1]. Compliance to the treatment is expected to be even lower among the general population outside the trial, which likely includes a higher proportion of elderly patients and those with comorbidities that render patients vulnerable to adverse events. A physician is therefore encouraged to modify the dose or the schedule appropriately with the goal of assisting each patient to adhere to the evidence-based treatment. …