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: Data on OS were available for four trials (1235 patients; Table 2). S-1-based chemotherapy was associated with a statistically significant 13% reduction in the hazard for death as compared with 5-Fu-based chemotherapy (HR, 0.87; 95% CI, 0.77–1.00; P = 0.043; Fig. 2). Data on PFS were available for five trials (1739 patients; Table 2). S-1-based chemotherapy was also associated with a clinically 13% reduction in the hazard for death as compared with 5-Fu-based chemotherapy, but this difference was not significant (HR, 0.87; 95% CI, 0.72–1.06; P = 0.160; Fig. 3). Response rate was stated in seven trials, which included 2077 patients (Table 2). S-1-based regimens was characterized by a significant 72% increase in the OR for response in comparison with 5-Fu-based chemotherapy (OR, 1.72; 95% CI, 1.09–2.70; P = 0.019; Fig. 4).
Affiliation: Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.