Survival benefit from S-1 as compared to Fluorouracil in Asian patients with advanced gastrointestinal cancer: a meta-analysis.
Bottom Line: Whether S-1 could replace 5-Fluorouracil (5-Fu) or not in the treatment of advanced gastrointestinal (GI) cancer (including advanced gastric cancer [AGS] and metastatic colorectal cancer [mCRC]) in Asian patients has been controversial.S-1-based chemotherapy was characterized by significantly higher incidences of diarrhea, fatigue and thrombocytopenia, and a lower incidence of nausea.This analysis provided strong evidence for survival benefits of S-1, and S-1-based chemotherapy could be considered to replace 5-Fu-based therapy for the treatment of advanced GI cancer in Asian patients.
Affiliation: Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.Show MeSH
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Mentions: Eight eligible trials(14)– (19,25,26) were identified, including four trials for mCRC and four trials for AGC. The flow diagram is shown in Figure 1. The analysis was conducted on the data of 2182 patients and randomly assigned to receive chemotherapy with S-1 or with 5-Fu, respectively. Of the eight trials, five trials were conducted in Japan,(15,17,19,25,26) and three in China.(14,16,18) The characteristics of the eight included trials are summarized in Table 1. More than 66.9% of patients have no history of chemotherapy. At the time of analysis, four trials were fully published journal articles,(14,19,21,25) while the rest of the trials were published only in abstract form. Finally, all trials used doublet or triplet combination chemotherapy except the Japan Clinical Oncology Group (JCOG) 9912 study(19) that used S-1 as the single agent.
Affiliation: Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.