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Gastric Cancer

, Volume 6, Supplement 1, pp 24–27 | Cite as

Longterm control of advanced and recurrent gastric cancer (ARGC) by S-1

  • Haruhiko Cho
  • Kazuo Konishi
  • Akira Tsuburaya
  • Osamu Kobayashi
  • Motonori Sairenji
  • Hisahiko Motohashi
  • Toshio Imada
Article

Abstract

Background

An oral tegafur compound, S-1 (TS-1®), was developed to potentiate antitumor activity and to reduce gastrointestinal toxicities for patients with gastric cancer. It has achieved a high response rate against advanced and recurrent gastric cancer (ARGC) in Japan; however, the efficacy and adverse reactions of longterm administration of S-1 remain to be elucidated.

Methods

Sixty-nine patients with ARGC treated with S-1 were studied; 58 patients had measurable lesions, while 11 patients did not. S-1 was orally administered at doses of between 40 and 60 mg/body twice daily for 28 days, followed by 14 days' rest, as one course.

Results

The overall response rate was 38% (complete response [CR], 2/58; partial response [PR], 20/58; stable disease [SD], 9/58; progressive disease [PD] 23/58). Response rate by target organ was 40% for the primary lesion, 45% for lymph node metastasis, 38% for peritoneal metastasis, and 25% for liver metastasis. When S-1 was administered as second-line chemotherapy (n = 25), the response rate was 36%. Of the 69 patients, 14 received S-1 for more than a year. The median survival time (MST) after S-1 administration in these 14 patients, including 3 patients with stable disease, was 918 days (range, 536 to 1107 days). There were no grade 3 to 4 toxicities in these 14 patients receiving longterm therapy with S-1.

Conclusion

S-1 therapy was performed with a high response rate, irrespective of the target organ or the presence of prior chemotherapy. Longterm administration of S-1 may benefit patients with ARGC, providing prolonged disease control with acceptable toxicities.

Key words

Gastric cancer Chemotherapy S-1 

References

  1. 1.
    Lokich, JJ, Ahlgren, JD, Gullo, JJ, Philips, JA, Fryer, JG 1989A prospective randomized comparison of continuous infusion fluorouracil with a conventional bolus schedule in metastatic colorectal carcinoma: a mid-Atlantic oncology program studyJ Clin Oncol742532PubMedGoogle Scholar
  2. 2.
    Koizumi, W, Kurihara, M, Nakano, S, Hasegawa, K 2000Phase II study of S-1, a novel oral derivative of 5-fluorouracil, in advanced gastric cancerOncology581917PubMedCrossRefGoogle Scholar
  3. 3.
    Sakata, Y, Ohtsu, A, Horikoshi, N, Sugimachi, K, Mitachi, Y, Taguchi, T 1998Late phase II study of novel oral fluoropyrimidine anticancer drug S-1 (1 M tegafur-0.4 M otastat potassium) in advanced gastric cancer patientsEur J Cancer34171520PubMedCrossRefGoogle Scholar
  4. 4.
    Japanese Gastric Cancer Association1998Japanese classification of gastric carcinoma 2nd English ed.Gastric Cancer11024PubMedGoogle Scholar
  5. 5.
    Therasse, P, Arbuck, SG, Eisenhauer, EA, Wanders, J, Kaplan, RS, Rubinstein, L,  et al. 2000New guidelines to evaluate the response to treatment in solid tumorsJ Natl Cancer I9220516Google Scholar
  6. 6.
    Wils, J 1996The treatment of advanced gastric cancerSemin Oncol23397406PubMedGoogle Scholar
  7. 7.
    Wils, JA, Klein, HO, Wagener, DJT 1991Sequential high-dose methotrexate and fluorouracil combined with doxorubicin — a step ahead in the treatment of advanced gastric cancer: a trial of the EORTC Gastrointestinal Tract Cooperative GroupJ Clin Oncol982731PubMedGoogle Scholar
  8. 8.
    Kelsen, D, Atiq, OT, Saltz, L 1992FAMTX versus etoposide, doxorubicin, and cisplatin: a random assignment trial in gastric cancerJ Clin Oncol105418PubMedGoogle Scholar
  9. 9.
    Kim, NK, Park, YS, Heo, DSA 1993phase III randomized study of 5-fluorouracil and cisplatin versus 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil alone in the treatment of advanced gastric cancerCancer7138138PubMedGoogle Scholar
  10. 10.
    Ohtsu, A, Shimada, Y, Yoshida, S 1994Phase II study of protracted infusional 5-fluorouracil combined with cisplatinum for advanced gastric cancer: report from the Japan Clinical Oncology Group (JCOG)Eur J Cancer30A20913PubMedGoogle Scholar
  11. 11.
    Shirasaka, T, Shimamato, Y, Ohshimo, H, Yamaguchi, M, Kato, T, Yonekura, K,  et al. 1996Development of a novel form of an oral 5-fluorouracil derivative (S-1) directed to the potentiation of the tumor selective cytotoxicity of 5-fluorouracil by two biochemical modulatorsAnticancer Drugs754857PubMedGoogle Scholar
  12. 12.
    Katai, H, Maruyama, K, Sasako, M, Sano, T, Okajima, K, Kinoshita, T,  et al. 1994Mode of recurrence after gastric cancer surgeryDig Surg1199103CrossRefGoogle Scholar
  13. 13.
    Tateishi, M, Ichiyoshi, Y, Kawano, T, Toda, T, Minamisono, Y, Nagasaki, S 1995Recurrent pattern of digestive tract carcinoma in the Japanese: comparison of gastric cancer to colon cancerInt Surg80414PubMedGoogle Scholar
  14. 14.
    Yoo, CH, Noh, SH, Shin, DW, Choi, SH, Min, JS 2000Recurrence following curative resection for gastric carcinomaBr J Surg8723642PubMedCrossRefGoogle Scholar
  15. 15.
    Kobayashi, O, Suzuki, K, Yoshikawa, T, Rino, Y, Tsuburaya, A, Sairenji, M,  et al. 1998A case of peritoneal recurrence of gastric cancer early detected with a diagnostic laparoscopyJpn J Gastroenterol Surg3122926Google Scholar
  16. 16.
    Hallissey, MT, Allum, WH, Roginski, C, Fielding, JWL 1988Palliative surgery for gastric cancerCancer624404PubMedGoogle Scholar
  17. 17.
    Kobayashi, O, Konishi, K, Kanarai, M, Cho, H, Yoshikawa, T, Tsuburaya, A,  et al. 2002Unusual survival for more than 2 years with peritoneal metastases of gastric cancerGastric Cancer54750PubMedGoogle Scholar
  18. 18.
    Kobayashi, O, Konishi, K, Kanari, M, Cho, H, Yoshikawa, T, Tsuburaya, A,  et al. 2001Significance of radical recurrent tumor resection for recurrent gastric cancer as assessed by prognosisJpn J Cancer Chemother28164750Google Scholar

Copyright information

© International and Japanese Gastric Cancer Associations 2003

Authors and Affiliations

  • Haruhiko Cho
    • 1
  • Kazuo Konishi
    • 1
  • Akira Tsuburaya
    • 1
  • Osamu Kobayashi
    • 1
  • Motonori Sairenji
    • 1
  • Hisahiko Motohashi
    • 1
  • Toshio Imada
    • 2
  1. 1.Department of Gastrointestinal SurgeryKanagawa Cancer CenterYokohamaJapan
  2. 2.Yokohama City University Medical Center Gastroenterological CenterYokohamaJapan

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