Most Read Articles
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course
Christina Lau, 22 Oct 2015
A 21-gene expression assay can identify patients with early-stage breast cancer who can skip adjuvant chemotherapy without facing an increased risk of recurrence at 5 years.
Cathy Chow, PhD, 27 Aug 2015

HER2-positive breast cancer tends to be more aggressive, has worse patient prognosis, and responds less to treatment. A two-pronged approach to block the HER pathway via pertuzumab (Perjeta®, Roche), a first-in-class HER dimerization inhibitor, in combination with trastuzumab and chemotherapy, may offer more treatment options for HER2-positive metastatic breast cancer patients as well as those with early breast cancer. 

Saras Ramiya, 25 Oct 2017
The first patient-reported outcomes study on durvalumab treatment after chemoradiation in locally advanced non-small cell lung cancer (NSCLC) shows patients’ quality of life is similar to that of the patients who received placebo.

S-1 combination therapy better improves outcome for gemcitabine-refractory pancreatic cancer than monotherapy

Audrey Abella
23 Aug 2017

S-1* combination therapy was associated with a higher response rate and longer progression-free survival (PFS) than S-1 monotherapy in patients with gemcitabine-refractory advanced pancreatic cancer, a new meta-analysis has found.

“Both combination regimens provided extraordinary results for patients with advanced [pancreatic cancer] who chose S-1 as the second-line therapy,” said the researchers.

Of the 623 patients included, 315 had undergone S-1 monotherapy and 308 underwent S-1 combination therapy. [Medicine (Baltimore) 2017;doi:10.1097/MD.0000000000007611]

Compared with patients undergoing S-1 monotherapy, those on S-1 combination therapy had a significantly higher response rate (RR, 1.75, 95 percent confidence interval [CI], 1.19–2.57; p=0.005) and longer PFS (hazard ratio [HR], 0.75, 95 percent CI, 0.62–0.91; p=0.005).

On subgroup analysis, better PFS was observed with S-1 combined with leucovorin (HR, 0.68; p=0.01) than irinotecan (CPT-11; HR, 0.77; p=0.16) or oxaliplatin (HR, 0.84; p=0.34), suggesting that the effect of S-1 plus leucovorin led to the longer PFS in the S-1 combination arm (HR, 0.75; p=0.005).

Additionally, S-1 combined with CPT-11 led to a higher response rate than S-1 monotherapy (RR, 3.07, 95 percent CI, 1.03–9.13).

“[T]he total dose and usage of [adjuvant] leucovorin might affect the final therapeutic efficacy … S-1 combined with both leucovorin and CPT-11 was a good therapeutic choice for [gemcitabine-refractory pancreatic cancer] patients,” said the researchers.

Both S-1 combination therapy and monotherapy were well tolerated with few adverse events such as neutropenia (n=26 and 22, respectively), diarrhoea (n=13 and 13), and nausea (n=14 and 8).

“A regimen that causes fewer adverse events can rapidly improve the physical and mental condition of the patient,” said the researchers, highlighting safety as an important consideration when introducing a new chemotherapeutic modality.

Overall, the findings suggest that both S1 monotherapy and combination therapy are potential alternatives to FOLFIRINOX**, the standard therapeutic regimen for gemcitabine-refractory pancreatic cancer, as it entails severe toxicity and side effects. [N Engl J Med 2011;364:1817-1825]

Furthermore, as most advanced pancreatic cancer cases entail local aggression or metastases, patients have a high likelihood of missing their chance for tumour resection, according to the researchers. Therefore, it is important to identify the therapeutic efficacy of various regimens that may help improve prognosis and guide therapeutic decisions for advanced pancreatic cancer, they added.

“[Both regimens] were practical and crucial in future clinical practice and clinical trials,” said the researchers, who called for further investigation to include other ethnicities as the study was limited to an Asian population.

 

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Most Read Articles
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course
Christina Lau, 22 Oct 2015
A 21-gene expression assay can identify patients with early-stage breast cancer who can skip adjuvant chemotherapy without facing an increased risk of recurrence at 5 years.
Cathy Chow, PhD, 27 Aug 2015

HER2-positive breast cancer tends to be more aggressive, has worse patient prognosis, and responds less to treatment. A two-pronged approach to block the HER pathway via pertuzumab (Perjeta®, Roche), a first-in-class HER dimerization inhibitor, in combination with trastuzumab and chemotherapy, may offer more treatment options for HER2-positive metastatic breast cancer patients as well as those with early breast cancer. 

Saras Ramiya, 25 Oct 2017
The first patient-reported outcomes study on durvalumab treatment after chemoradiation in locally advanced non-small cell lung cancer (NSCLC) shows patients’ quality of life is similar to that of the patients who received placebo.