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Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 4/2014

01-10-2014 | Original Article

Phase I study of adjuvant gemcitabine or S-1 in patients with biliary tract cancers undergoing major hepatectomy: KHBO1003 study

Authors: Shogo Kobayashi, Hiroaki Nagano, Daisuke Sakai, Hidetoshi Eguchi, Etsuro Hatano, Masashi Kanai, Satoru Seo, Kojiro Taura, Yutaka Fujiwara, Tetsuo Ajiki, Shigekazu Takemura, Shoji Kubo, Hiroaki Yanagimoto, Hideyoshi Toyokawa, Akihito Tsuji, Hiroaki Terajima, Satoshi Morita, Tatsuya Ioka

Published in: Cancer Chemotherapy and Pharmacology | Issue 4/2014

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Abstract

Background

Standardized adjuvant therapy is not performed after major hepatectomy for biliary tract cancer (BTC) because of frequent adverse events, which may be caused by insufficient liver function. Therefore, the aim of this multicenter study (KHBO1003) was to determine the safety protocol for adjuvant chemotherapy after major hepatectomy.

Methods

Within 12 weeks of R0 or R1 major hepatectomy (hemihepatectomy or trisectionectomy) for BTC, the following adjuvant chemotherapy was performed for 6 months: 800–1,000 mg/m2 gemcitabine on days 1, 8, and 15 and then every 3–4 weeks or 40–80 mg/m2/day S-1 on days 1–28 and every 3–6 weeks. Major dose-limited toxicity (DLT) was defined as grade 4 hematotoxicity, grade 3/4 febrile neutropenia, grade 3/4 non-hematotoxicity, skipped gemcitabine on days 8 and 15, or halting the course at or after 14 days. Dose-escalation and de-escalation decisions were based on the continual reassessment method. Every three patients were alternately assigned to each arm.

Results

Thirty-three patients (14 intrahepatic bile duct, 1 gall bladder, 18 extrahepatic bile duct) were enrolled in this study from February 2011 to July 2012 (n = 18 gemcitabine, n = 15 S-1). At 10 % of DLT, the recommended dose was 1,000 mg/m2 gemcitabine biweekly and 80 mg/m2/day S-1 on days 1–28 and every 6 weeks. Major DLT and adverse drug reactions were neutropenia. No grade 3 or 4 non-hematological adverse events were noted.

Conclusion

We determined RDs for gemcitabine and S-1 adjuvant chemotherapy after major hepatectomy with a DLT that does not exceed 10 %.
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Metadata
Title
Phase I study of adjuvant gemcitabine or S-1 in patients with biliary tract cancers undergoing major hepatectomy: KHBO1003 study
Authors
Shogo Kobayashi
Hiroaki Nagano
Daisuke Sakai
Hidetoshi Eguchi
Etsuro Hatano
Masashi Kanai
Satoru Seo
Kojiro Taura
Yutaka Fujiwara
Tetsuo Ajiki
Shigekazu Takemura
Shoji Kubo
Hiroaki Yanagimoto
Hideyoshi Toyokawa
Akihito Tsuji
Hiroaki Terajima
Satoshi Morita
Tatsuya Ioka
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 4/2014
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-014-2543-4

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