Original Article

Cancer Chemotherapy and Pharmacology

, Volume 73, Issue 2, pp 389-396

First online:

Randomized controlled study of gemcitabine plus S-1 combination chemotherapy versus gemcitabine for unresectable pancreatic cancer

  • Kentaro SudoAffiliated withDepartment of Gastroenterology, Chiba Cancer Center Email author 
  • , Takeshi IshiharaAffiliated withDepartment of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University
  • , Nobuto HirataAffiliated withDepartment of Gastroenterology, Kameda Medical Center
  • , Fumiaki OzawaAffiliated withDepartment of Hepato-biliary-pancreatic Surgery, Saitama Medical Center, Saitama Medical University
  • , Tadashi OhshimaAffiliated withDepartment of Gastroenterology, Saitama Red Cross Hospital
  • , Ryosaku AzemotoAffiliated withDepartment of Gastroenterology, Kimitsu Chuo Hospital
  • , Kenji ShimuraAffiliated withDepartment of Gastroenterology, Asahi General Hospital
  • , Takeshi NiheiAffiliated withDepartment of Internal Medicine, Mito Saiseikai General Hospital
  • , Takayoshi NishinoAffiliated withDepartment of Gastroenterology, Tokyo Women’s Medical University Yachiyo Medical Center
    • , Akihiko NakagawaAffiliated withDepartment of Gastroenterology, Numazu City Hospital
    • , Kazuyoshi NakamuraAffiliated withDepartment of Gastroenterology, Chiba Cancer Center
    • , Taro HaraAffiliated withDepartment of Gastroenterology, Chiba Cancer Center
    • , Motohisa TadaAffiliated withDepartment of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University
    • , Rintaro MikataAffiliated withDepartment of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University
    • , Katsunobu TawadaAffiliated withDepartment of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University
    • , Osamu YokosukaAffiliated withDepartment of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University
    • , So NakajiAffiliated withDepartment of Gastroenterology, Kameda Medical Center
    • , Taketo YamaguchiAffiliated withDepartment of Gastroenterology, Chiba Cancer Center

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Abstract

Purpose

The aim of this study was to evaluate efficacy and safety of gemcitabine plus S-1 (GS) combination chemotherapy in patients with unresectable pancreatic cancer.

Methods

Patients were randomly assigned to receive GS (oral S-1 60 mg/m2 daily on days 1–15 every 3 weeks and gemcitabine 1,000 mg/m2 on days 8 and 15) or gemcitabine (1,000 mg/m2 on days 1, 8, and 15 every 4 weeks). The primary endpoint was progression-free survival (PFS).

Results

One hundred and one patients were randomly assigned. PFS was significantly longer in the GS arm with an estimated hazard ratio (HR) of 0.65 (95 % CI 0.430.98; P = 0.039; median 5.3 vs 3.8 months). Objective response rate (ORR) was also better in the GS arm (21.6 vs 6 %, P = 0.048). Median survival was 8.6 months for GS and 8.6 months for GEM (HR 0.93; 95 % CI 0.611.41; P = 0.714). Grade 3–4 neutropenia (44 vs 19.6 %, P = 0.011) and thrombocytopenia (26 vs 8.7 %, P = 0.051) were more frequent in the GS arm.

Conclusions

GS therapy improved PFS and ORR with acceptable toxicity profile in patients with unresectable pancreatic cancer.

Keywords

Pancreatic cancer S-1 Gemcitabine Randomized controlled study