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. (6th November 2019)

• Record Type: Journal Article
• Authors: Demachi, Ken; Bando, Hideaki; Nomura, Hisanaga; Shitara, Kohei; Yoshino, Takayuki; Yamaguchi, Masakazu; Kawasaki, Toshikatsu
• Is Part Of: Japanese journal of clinical oncology. Volume 50:Number 2(2020)
• Page Start: 129
• Page End: 137
• Publication Date: 2019-11-06
• Subjects: gastric cancer -- renal Impairment -- oxaliplatin -- S-1; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyz157
• Languages: English
• ISSNs: 0368-2811

Abstract

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/m 2 ) plus oxaliplatin (100 mg/m 2 ), 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/m 2 or 40 mg/m 2 ) 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 m 2, 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. Abstract : S-1 plus oxaliplatin in advanced gastric cancer patients with impaired renal function may be safely administered, and efficacy is likely to be maintained with appropriate dose modification.