Most Read Articles
Naomi Rodrig, 15 Jun 2016
An interim analysis from the multinational phase III CASTOR trial, presented recently at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, showed that adding daratumumab to the standard two-drug regimen of bortezomib and dexamethasone markedly improved outcomes of patients with recurrent or refractory multiple myeloma.
Saras Ramiya, 14 Nov 2017
Accord Healthcare launches Accord Bortezomib® (bortezomib 3.5 mg per vial) for the treatment of patients with multiple myeloma and mantle cell lymphoma in Malaysia.
Su Ping Chuah, 01 Aug 2014

New immune therapies with new targets that can induce long-term remission in patients with advanced cutaneous T-cell lymphoma (CTCL) are needed, says an expert.

Radha Chitale, 01 Aug 2014

German experts came together to update guidelines on melanoma management and create consensus out of fragmented standards of care by experts across multiple fields.

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
Naomi Rodrig, 15 Jun 2016
An interim analysis from the multinational phase III CASTOR trial, presented recently at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, showed that adding daratumumab to the standard two-drug regimen of bortezomib and dexamethasone markedly improved outcomes of patients with recurrent or refractory multiple myeloma.
Saras Ramiya, 14 Nov 2017
Accord Healthcare launches Accord Bortezomib® (bortezomib 3.5 mg per vial) for the treatment of patients with multiple myeloma and mantle cell lymphoma in Malaysia.
Su Ping Chuah, 01 Aug 2014

New immune therapies with new targets that can induce long-term remission in patients with advanced cutaneous T-cell lymphoma (CTCL) are needed, says an expert.

Radha Chitale, 01 Aug 2014

German experts came together to update guidelines on melanoma management and create consensus out of fragmented standards of care by experts across multiple fields.