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Published in: Journal of Cancer Research and Clinical Oncology 12/2013

01-12-2013 | Original Paper

Impact of adding cisplatin to S-1 in elderly patients with advanced gastric cancer

Authors: Tetsuji Terazawa, Satoru Iwasa, Atsuo Takashima, Hitoshi Nishitani, Yoshitaka Honma, Ken Kato, Tetsuya Hamaguchi, Yasuhide Yamada, Yasuhiro Shimada

Published in: Journal of Cancer Research and Clinical Oncology | Issue 12/2013

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Abstract

Purpose

We retrospectively examined the efficacy and safety of S-1 alone or S-1 plus cisplatin (SP) for elderly patients with advanced gastric cancer because the benefit of adding cisplatin in these patients still remains unclear.

Patients and methods

Among 175 patients aged 70 years or older who received S-1 alone or SP as a first-line therapy between April 2000 and November 2010 at our institution, 104 patients who met eligibility criteria were examined. We investigated safety and efficacy of S-1 and SP.

Results

Among these 104 patients, 73 patients received S-1 and 31 patients received SP. The median age was 75 years in the S-1 group and 74 years in the SP group. The response rate was 26.3 % in the S-1 group and 44.0 % in the SP group. Major grade 3 or higher adverse events were observed as follows (S-1 vs. SP): nausea (1.4 vs. 16.1 %), anorexia (16.4 vs. 41.9 %), neutropenia (4.1 vs. 35.5 %), and febrile neutropenia (0 vs. 9.7 %). The median overall survival (OS) was 10.4 months in the S-1 group and 17.8 months in the SP group. Treatment of SP and histology of intestinal type were detected as independent, good prognostic factors in multivariate analysis.

Conclusion

SP might improve OS with some added toxicity compared to S-1 alone in elderly patients with advanced gastric cancer.
Literature
go back to reference Boku N, Yamamoto S, Fukuda H, Shirao K, Doi T, Sawaki A, Koizumi W, Saito H, Yamaguchi K, Takiuchi H, Nasu J, Ohtsu A, Gastrointestinal Oncology Study Group of the Japan Clinical Oncology Group (2009) Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol 10:1063–1069CrossRefPubMed Boku N, Yamamoto S, Fukuda H, Shirao K, Doi T, Sawaki A, Koizumi W, Saito H, Yamaguchi K, Takiuchi H, Nasu J, Ohtsu A, Gastrointestinal Oncology Study Group of the Japan Clinical Oncology Group (2009) Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol 10:1063–1069CrossRefPubMed
go back to reference Chen JS, Chao Y, Hsieh RK, Cheng AL, Chen PM, Chiou TJ, Chao TY, Yeh KH, Chen LT, Whang-Peng J (2011) A phase II and pharmacokinetic study of first line S-1 for advanced gastric cancer in Taiwan. Cancer Chemother Pharmacol 67:1281–1289CrossRefPubMed Chen JS, Chao Y, Hsieh RK, Cheng AL, Chen PM, Chiou TJ, Chao TY, Yeh KH, Chen LT, Whang-Peng J (2011) A phase II and pharmacokinetic study of first line S-1 for advanced gastric cancer in Taiwan. Cancer Chemother Pharmacol 67:1281–1289CrossRefPubMed
go back to reference Extermann M, Hurria A (2007) Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 25:1824–1831CrossRefPubMed Extermann M, Hurria A (2007) Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 25:1824–1831CrossRefPubMed
go back to reference Fonck M, Brunet R, Becouarn Y, Legoux JL, Dauba J, Cany L, Smith D, Auby D, Terrebonne E, Traissac L, Mertens C, Soubeyran P, Bellera C, Rainfray M, Mathoulin-Pélissier S (2011) Evaluation of efficacy and safety of FOLFIRI for elderly patients with gastric cancer: a first-line phase II study. Clin Res Hepatol Gastroenterol 35:823–830CrossRefPubMed Fonck M, Brunet R, Becouarn Y, Legoux JL, Dauba J, Cany L, Smith D, Auby D, Terrebonne E, Traissac L, Mertens C, Soubeyran P, Bellera C, Rainfray M, Mathoulin-Pélissier S (2011) Evaluation of efficacy and safety of FOLFIRI for elderly patients with gastric cancer: a first-line phase II study. Clin Res Hepatol Gastroenterol 35:823–830CrossRefPubMed
go back to reference Glimelius B, Ekström K, Hoffman K, Graf W, Sjödén PO, Haglund U, Svensson C, Enander LK, Linné T, Sellström H, Heuman R (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168CrossRefPubMed Glimelius B, Ekström K, Hoffman K, Graf W, Sjödén PO, Haglund U, Svensson C, Enander LK, Linné T, Sellström H, Heuman R (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168CrossRefPubMed
go back to reference Hurria A, Gupta S, Zauderer M, Zuckerman EL, Cohen HJ, Muss H, Rodin M, Panageas KS, Holland JC, Saltz L, Kris MG, Noy A, Gomez J, Jakubowski A, Hudis C, Kornblith AB (2005) Developing a cancer-specific geriatric assessment: a feasibility study. Cancer 104:1998–2005CrossRefPubMed Hurria A, Gupta S, Zauderer M, Zuckerman EL, Cohen HJ, Muss H, Rodin M, Panageas KS, Holland JC, Saltz L, Kris MG, Noy A, Gomez J, Jakubowski A, Hudis C, Kornblith AB (2005) Developing a cancer-specific geriatric assessment: a feasibility study. Cancer 104:1998–2005CrossRefPubMed
go back to reference Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, Lichtman SM, Gajra A, Bhatia S, Katheria V, Klapper S, Hansen K, Ramani R, Lachs M, Wong FL, Tew WP (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29:3457–3465PubMedCentralCrossRefPubMed Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, Lichtman SM, Gajra A, Bhatia S, Katheria V, Klapper S, Hansen K, Ramani R, Lachs M, Wong FL, Tew WP (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29:3457–3465PubMedCentralCrossRefPubMed
go back to reference Kitamura K, Yamaguchi T, Taniguchi H, Hagiwara A, Yamane T, Sawai K, Takahashi T (1996) Clinicopathological characteristics of gastric cancer in the elderly. Br J Cancer 73:798–802PubMedCentralCrossRefPubMed Kitamura K, Yamaguchi T, Taniguchi H, Hagiwara A, Yamane T, Sawai K, Takahashi T (1996) Clinicopathological characteristics of gastric cancer in the elderly. Br J Cancer 73:798–802PubMedCentralCrossRefPubMed
go back to reference Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9:215–221CrossRefPubMed Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9:215–221CrossRefPubMed
go back to reference Koizumi W, Akiya T, Sato A, Sakuyama T, Sasaki E, Tomidokoro T, Hamada T, Fujimori M, Kikuchi Y, Shimada K, Mine T, Yamaguchi K, Sasaki T, Kurihara M (2010) Phase II study of S-1 as first-line treatment for elderly patients over 75 years of age with advanced gastric cancer: the Tokyo Cooperative Oncology Group study. Cancer Chemother Pharmacol 65:1093–1099CrossRefPubMed Koizumi W, Akiya T, Sato A, Sakuyama T, Sasaki E, Tomidokoro T, Hamada T, Fujimori M, Kikuchi Y, Shimada K, Mine T, Yamaguchi K, Sasaki T, Kurihara M (2010) Phase II study of S-1 as first-line treatment for elderly patients over 75 years of age with advanced gastric cancer: the Tokyo Cooperative Oncology Group study. Cancer Chemother Pharmacol 65:1093–1099CrossRefPubMed
go back to reference Launay-Vacher V, Chatelut E, Lichtman SM, Wildiers H, Steer C, Aapro M, International Society of Geriatric Oncology (2007) Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations. Ann Oncol 18:1314–1321CrossRefPubMed Launay-Vacher V, Chatelut E, Lichtman SM, Wildiers H, Steer C, Aapro M, International Society of Geriatric Oncology (2007) Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations. Ann Oncol 18:1314–1321CrossRefPubMed
go back to reference Lee JL, Kang YK, Kang HJ, Lee KH, Zang DY, Ryoo BY, Kim JG, Park SR, Kang WK, Shin DB, Ryu MH, Chang HM, Kim TW, Baek JH, Min YJ (2008) A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Br J Cancer 99:584–590PubMedCentralCrossRefPubMed Lee JL, Kang YK, Kang HJ, Lee KH, Zang DY, Ryoo BY, Kim JG, Park SR, Kang WK, Shin DB, Ryu MH, Chang HM, Kim TW, Baek JH, Min YJ (2008) A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Br J Cancer 99:584–590PubMedCentralCrossRefPubMed
go back to reference Murad AM, Santiago FF, Petroianu A, Rocha PR, Rodrigues MA, Rausch M (1993) Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer 72:37–41CrossRefPubMed Murad AM, Santiago FF, Petroianu A, Rocha PR, Rodrigues MA, Rausch M (1993) Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer 72:37–41CrossRefPubMed
go back to reference Nagashima F, Ohtsu A, Yoshida S, Ito K (2005) Japanese nationwide post-marketing survey of S-1 in patients with advanced gastric cancer. Gastric Cancer 8:6–11CrossRefPubMed Nagashima F, Ohtsu A, Yoshida S, Ito K (2005) Japanese nationwide post-marketing survey of S-1 in patients with advanced gastric cancer. Gastric Cancer 8:6–11CrossRefPubMed
go back to reference Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108CrossRefPubMed Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108CrossRefPubMed
go back to reference Pyrhonen S, Kuitunen T, Nyandoto P, Kouri M (1995) Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with nonresectable gastric cancer. Br J Cancer 71:587–591PubMedCentralCrossRefPubMed Pyrhonen S, Kuitunen T, Nyandoto P, Kouri M (1995) Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with nonresectable gastric cancer. Br J Cancer 71:587–591PubMedCentralCrossRefPubMed
go back to reference Seol YM, Song MK, Choi YJ, Kim GH, Shin HJ, Song GA, Chung JS, Cho GJ (2009) Oral fluoropyrimidines (Capecitabine or S-1) and cisplatin as first line treatment in elderly patients with advanced gastric cancer: a retrospective study. Jpn J Clin Oncol 39:43–48CrossRefPubMed Seol YM, Song MK, Choi YJ, Kim GH, Shin HJ, Song GA, Chung JS, Cho GJ (2009) Oral fluoropyrimidines (Capecitabine or S-1) and cisplatin as first line treatment in elderly patients with advanced gastric cancer: a retrospective study. Jpn J Clin Oncol 39:43–48CrossRefPubMed
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216CrossRefPubMed
go back to reference Tsushima T, Hironaka S, Boku N, Machida N, Yamazaki K, Yasui H, Fukutomi A, Todaka A, Taniguchi H, Onozawa Y, Taku K (2013) Comparison of safety and efficacy of S-1 monotherapy and S-1 plus cisplatin therapy in elderly patients with advanced gastric cancer. Int J Clin Oncol 18:10–16CrossRefPubMed Tsushima T, Hironaka S, Boku N, Machida N, Yamazaki K, Yasui H, Fukutomi A, Todaka A, Taniguchi H, Onozawa Y, Taku K (2013) Comparison of safety and efficacy of S-1 monotherapy and S-1 plus cisplatin therapy in elderly patients with advanced gastric cancer. Int J Clin Oncol 18:10–16CrossRefPubMed
go back to reference Xiang XJ, Zhang L, Qiu F, Yu F, Zhan ZY, Feng M, Yan J, Zhao JG, Xiong JP (2012) A phase II study of capecitabine plus oxaliplatin as first-line chemotherapy in elderly patients with advanced gastric cancer. Chemotherapy 58:1–7CrossRefPubMed Xiang XJ, Zhang L, Qiu F, Yu F, Zhan ZY, Feng M, Yan J, Zhao JG, Xiong JP (2012) A phase II study of capecitabine plus oxaliplatin as first-line chemotherapy in elderly patients with advanced gastric cancer. Chemotherapy 58:1–7CrossRefPubMed
Metadata
Title
Impact of adding cisplatin to S-1 in elderly patients with advanced gastric cancer
Authors
Tetsuji Terazawa
Satoru Iwasa
Atsuo Takashima
Hitoshi Nishitani
Yoshitaka Honma
Ken Kato
Tetsuya Hamaguchi
Yasuhide Yamada
Yasuhiro Shimada
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 12/2013
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-013-1537-7

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