Clinical impact of renal impairment on the safety and efficacy of S-1 plus oxaliplatin in patients with advanced gastric cancer: a single institutional study.

Abstract

BACKGROUNDS:

S-1 plus oxaliplatin appears effective in chemo-naïve patients with advanced gastric cancer. However, comprehensive safety and efficacy data for S-1 plus oxaliplatin is limited for patients with impaired renal function.

METHODS:

We retrospectively extracted data from advanced gastric cancer patients with normal renal function (normal group, CLcr ≥ 60 ml/min), who were treated with standard doses of S-1 (80 mg/m2) plus oxaliplatin (100 mg/m2), and patients with impaired renal function (impaired group, CLcr < 60 ml/min) who were treated with standard or reduced doses of S-1 (60 mg/m2 or 40 mg/m2) plus standard doses of oxaliplatin. Treatment efficacy and safety between the groups were compared.

RESULTS:

Data from 100 normal patients and 42 patients with impaired renal function were extracted. Baseline characteristics differed significantly between the two groups, including age (median, 64 vs 72 years, P < 0.0001) and body surface area (median, 1.68 vs 1.51 m2, P < 0.0001). In the impaired group, 66.6% (28/42) started with a reduced dose. Within the impaired group, more patients had a reduced initial S-1 dose when CLcr <50 ml/min (77.3%). The median progression-free and overall survival between the normal and impaired groups was 6.1 vs 5.7 months (P = 0.698) and 16.1 vs 18.5 months (P = 0.638), respectively.

CONCLUSIONS:

S-1 plus oxaliplatin in advanced gastric cancer patients with impaired renal function appears safe and has demonstrated efficacy given appropriate dose modification.

• Authors: Ken Demachi, Hideaki Bando, Hisanaga Nomura, Kohei Shitara, Takayuki Yoshino, Masakazu Yamaguchi, Toshikatsu Kawasaki
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 50 Issue 2 Pg. 129-137 (Feb 17 2020) ISSN: 1465-3621 [Electronic] England
• PMID: 31693138 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Drug Combinations
• Oxaliplatin
• S 1 (combination)
• Tegafur
• Oxonic Acid
• Creatinine

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Creatinine (blood)
• Dose-Response Relationship, Drug
• Drug Combinations
• Female
• Humans
• Male
• Middle Aged
• Oxaliplatin (therapeutic use)
• Oxonic Acid (therapeutic use)
• Renal Insufficiency (physiopathology)
• Retrospective Studies
• Stomach Neoplasms (blood, drug therapy, pathology, physiopathology)
• Tegafur (therapeutic use)
• Treatment Outcome