Effectiveness and safety profile of S-1-based chemotherapy compared with capecitabine-based chemotherapy for advanced gastric and colorectal cancer: A meta-analysis

Jia-Xiang Ye, Ai-Qun Liu, Lian-Ying Ge, Shao-Zhang Zhou, Zhong-Guo Liang, Jia-Xiang Ye, Ai-Qun Liu, Lian-Ying Ge, Shao-Zhang Zhou, Zhong-Guo Liang

Abstract

The aim of the present analysis was to compare the efficacy and safety profile of S-1-based chemotherapy (SBCT) versus capecitabine-based chemotherapy (CBCT) for advanced gastric cancer (AGC) and advanced colorectal cancer (ACRC). A meta-analysis was performed, which included eligible randomized controlled trials (RCTs) that were identified using RevMan 5.1.0 software. A total of 1,064 patients from 11 RCTs, comprising of 527 patients in the SBCT group and 537 patients in the CBCT group, were included in the analysis. For AGC, the meta-analysis of overall survival (OS) [hazard ratio (HR), 0.98; 95% confidence interval (CI), 0.85-1.12], time to progression (HR, 0.95; 95% CI, 0.80-1.12) and overall response rate (ORR) [odds ratio (OR), 1.06; 95% CI, 0.72-1.55] of patients in the SBCT group indicated no statistical significance when compared with those in the CBCT group. Furthermore, for ACRC, a pooled analysis demonstrated no significant difference between the SBCT and CBCT groups (OS: HR, 0.82; 95% CI, 0.61-1.10; progression-free survival: HR, 0.79; 95% CI=0.60-1.04; ORR: OR, 1.27; 95% CI, 0.91-1.78). The statistically significant differences identified in the overall meta-analysis indicated a low incidence of grade 3-4 hand-foot-syndrome (OR, 0.15; 95% CI, 0.06-0.36) in the SBCT group; however no statistically significant difference was observed in the incidence of grade 3-4 anemia, thrombocytopenia, leucopenia, neutropenia, diarrhea, stomatitis or nausea/vomiting. The SBCT treatment exhibited similar efficacy and an approximately equivalent safety profile compared with the CBCT treatment and was an alternative to CBCT for patients with AGC or ACRC; however, further investigation is required to provide confirmation.

Keywords: S-1; advanced colorectal cancer; advanced gastric cancer; capecitabine; meta-analysis.

Figures

Figure 1
Figure 1
Flow chart displaying the process of study selection for the present meta-analysis. ASCO, American Society of Clinical Oncology.
Figure 2
Figure 2
Forest plot of the odds ratio of the overall response rate. CI, confidence interval.
Figure 3
Figure 3
Forest plot of the hazard ratio of time to progression or progression-free survival. CI, confidence interval.
Figure 4
Figure 4
Forest plot of the hazard ratio of overall survival. CI, confidence interval.

References

    1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917.
    1. Meyerhardt JA, Mayer RJ. Systemic therapy for colorectal cancer. N Engl J Med. 2005;352:476–487.
    1. Miwa M, Ura M, Nishida M, et al. Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumours by enzymes concentrated in human liver and cancer tissue. Eur J Cancer. 1998;34:1274–1281.
    1. Shirasaka T, Shimamato Y, Ohshimo H, et al. Development 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 modulators. Anticancer Drugs. 1996;7:548–557.
    1. Xu RH, Sun GP, Lu HS, et al. A phase III study of S-1 plus cisplatin versus fluorouracil plus cisplatin in patients with advanced gastric or gastroesophageal junction adenocarcinoma. Journal of Clinical Oncology. 2013;31
    1. Muro K, Boku N, Shimada Y, et al. Irinotecan plus S-1 (IRIS) versus fluorouracil and folinic acid plus irinotecan (FOLFIRI) as second-line chemotherapy for metastatic colorectal cancer: a randomised phase 2/3 non-inferiority study (FIRIS study) Lancet Oncol. 2010;11:853–860.
    1. Hong YS, Park YS, Lim HY, et al. S-1 plus oxaliplatin versus capecitabine plus oxaliplatin for first-line treatment of patients with metastatic colorectal cancer: a randomised, non-inferiority phase 3 trial. Lancet Oncol. 2012;13:1125–1132.
    1. Kim GM, Jeung HC, Rha SY, et al. A randomized phase II trial of S-1-oxaliplatin versus capecitabine-oxaliplatin in advanced gastric cancer. Eur J Cancer. 2012;48:518–526.
    1. Lee JL, Kang YK, Kang HJ, et al. A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Br J Cancer. 2008;99:584–590.
    1. Zang DY, Chung IJ, Oh HS, Park KU, Lee KH, Han B, Choi DR, Kim HS, Kim JH. Randomized phase II study of oxaliplatin and S-1 (OS) versus oxaliplatin and capecitabine (XELOX) in patients with metastatic or recurrent colorectal cancer. J Clin Oncol. 2012;30:595.
    1. Ba Z, Wu M, Wang LJ, Zhang HQ. Curative effect analysis of S-1 combined with cisplatin or capecitabine combined with cisplatin in the treatment of advanced gastric cancer. Chinese General Practice. 2012;15:672–676.
    1. Lu HM, Zhou LL, Liu JJ, Liu SH. Clinical study of oxaliplatin plus TS-1 or capecitabine in the treatment of advanced colon cancer. Cancer Research and Clinic. 2012;24:613–615.
    1. Qiu GQ, Xu LZ, Lin ZC, Chen YQ. Clinical observation of S-1 in the treatment of old patients with advanced gastric carcinoma. Chin J Clin Oncol Rehabil. 2011;18:61–63.
    1. Sun DS, Zhang GR, Ma LG, Zou YH. The comparative effect of capecitabine and tegafur/gimeracil/oteracil(S-1) on advanced colorectal cancer. Chin J Prim Med Pharm. 2013;20:826–827.
    1. Xiong HL, Liu XQ, Sun AH, He Y, Li J, Yuan X. Clinical comparison of docetaxel combined with S-1 or Capicitabine in treating advanced gastric carcinoma. Modern Oncology. 2013;21:581–584.
    1. Yan Z, Zhao TX, Xing Y, Chen D, He LL. Curative effect analysis of S-1 combined with cisplatin in the treatment of advanced gastric cancer. Progress in Modern Biomedicine. 2012;12:5324–5326.
    1. Zhang HY, Sun LZ. The clinical study of domestic compound Tegafur capsule first-line Therapy for patients with elderly advanced gastric cancer. Medical Innovation of China. 2010;7:94–96.
    1. Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 2007;8:16.
    1. Higgins J, Green S. [Accessed August 31, 2013];The Chochrane Collaboration: Cochrane Handbook for Systematic Reviews of Interventions. 2011 .
    1. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–216.
    1. Tsuburaya A, Morita S, Kodera Y, et al. A randomized phase II trial to elucidate the efficacy of capecitabine plus cisplatin (XP) and S-1 plus cisplatin (SP) as a first-line treatment for advanced gastric cancer: XP ascertainment vs. SP randomized PII trial (XParTS II) BMC Cancer. 2012;12:307.
    1. Okines AFC, Norman AR, McCloud P, Kang YK, Cunningham D. Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combination chemotherapy for the treatment of advanced oesophago-gastric cancer. Ann Oncol. 2009;20:1529–1534.
    1. Huang J, Cao Y, Wu L, Liao C, He Y, Gao F. S-1-based therapy versus 5-FU-based therapy in advanced gastric cancer: a meta-analysis. Med Oncol. 2011;28:1004–1011.
    1. Ma Y, Tang L, Wang HX, Xu YC, Ma Y, Zhang FC. Capecitabine for the treatment for advanced gastric cancer: efficacy, safety and ethnicity. J Clin Pharm Ther. 2012;37:266–275.
    1. Ajani JA, Faust J, Ikeda K, et al. Phase I pharmacokinetic study of S-1 plus cisplatin in patients with advanced gastric carcinoma. J Clin Oncol. 2005;23:6957–6965.
    1. Kong SY, Lim HS, Nam BH, et al. Association of CYP2A6 polymorphisms with S-1 plus docetaxel therapy outcomes in metastatic gastric cancer. Pharmacogenomics. 2009;10:1147–1155.
    1. Fuse N, Fukuda H, Yamada Y, et al. Updated results of randomized phase III study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG 9912) J Clin Oncol (ASCO Annual Meeting abstracts) 2009;27:4514.
    1. Ajani JA, Rodriguez W, Bodoky G, et al. Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol. 2010;28:1547–1553.

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