Gemcitabine and S-1 combination chemotherapy versus gemcitabine alone for locally advanced and metastatic pancreatic cancer: a meta-analysis of randomized controlled trials in Asia. (August 2015)

• Record Type: Journal Article
• Authors: Li, Yanxun; Sun, Jinjin; Jiang, Zhijia; Zhang, Linqiang; Liu, Geng
• Is Part Of: Journal of chemotherapy. Volume 27:Number 4(2015:Aug.)
• Page Start: 227
• Page End: 234
• Publication Date: 2015-08
• Subjects: Chemotherapy -- Periodicals; Drug Therapy -- Periodicals; 615.58
• DOI: 10.1179/1973947815Y.0000000013
• Languages: German
• ISSNs: 1120-009X

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <sec> <title>Introduction:</title> <p>After decades of research, pancreatic cancer is still a devastating disease. The aim of this article was to assess the efficacy and safety of combination chemotherapy with gemcitabine (GEM) and S-1 (GS) therapy compared with GEM alone therapy in patients with locally advanced or metastatic pancreatic cancer.</p> </sec> <sec> <title>Methods:</title> <p>Relevant trials were identified by searching databases. Five trials were selected in this article. The indicators we used were overall response rate, disease control rate, 1-year survival rate and haematological toxicities.</p> </sec> <sec> <title>Results:</title> <p>Meta-analysis of the pooled data demonstrated that the overall response rate (risk ratio, RR = 2.52, 95% confidence interval, CI: 1.85–3.42, <italic>P</italic> < 0.00001) and disease control rate (RR = 1.24, 95% CI: 1.12–1.37, <italic>P</italic> < 0.0001) were significantly different for the GS and GEM alone chemotherapies. Among the group of patients, 43.4% in the GS group and 31.4% in the GEM group survived more than a year. According to this, patients who use the GS regiment may have a better prognosis than the GEM regiment (RR = 1.62, 95% CI: 1.12–2.33, <italic>P</italic> = 0.04). The combination chemotherapy with GEM and S-1 group had higher haematological toxicities including neutropaenia (RR = 1.58, 95% CI: 1.17–2.14, <italic>P</italic> = 0.003) and thrombocytopaenia (RR = 1.85, 95% CI: 1.28–2.67, <italic>P</italic> = 0.001). The incidence of anaemia was much the same in the two groups (RR = 1.22, 95% CI: 0.87–1.70, <italic>P</italic> = 0.24).</p> </sec> <sec> <title>Discussion:</title> <p>Overall response rate and disease control rate as well as 1-year survival rate in patients who received GS were superior to those treated with GEM alone. Combination chemotherapy with GEM and S-1 may offer greater benefits in the treatment of pancreatic cancer than GEM alone, although the GS group had higher haematological toxicities. Combination chemotherapy with GEM and S-1 might be an option of first-line chemotherapy for pancreatic cancer patients, at least in Asia.</p> <p>Mini Abstract: This systematic review analysing randomized controlled trials (RCTs) comparing S-1 combination chemotherapy versus GEM alone for locally advanced and metastatic pancreatic cancer demonstrated greater efficacy for S-1 combination in term of response, disease control and 1-year survival proportion.</p> </sec> </sec> </abstract>