Japanese journal of clinical oncology | 2019
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\nS-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.\n\n\nMETHODS\nWe retrospectively extracted data from advanced gastric cancer patients with normal renal function (normal group, CLcr ≥ 60\xa0ml/min), who were treated with standard doses of S-1 (80\xa0mg/m2) plus oxaliplatin (100\xa0mg/m2), and patients with impaired renal function (impaired group, CLcr < 60\xa0ml/min) who were treated with standard or reduced doses of S-1 (60\xa0mg/m2 or 40\xa0mg/m2) plus standard doses of oxaliplatin. Treatment efficacy and safety between the groups were compared.\n\n\nRESULTS\nData 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\xa0years, P\xa0<\xa00.0001) and body surface area (median, 1.68 vs 1.51\xa0m2, P\xa0<\xa00.0001). 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\xa0ml/min (77.3%). The median progression-free and overall survival between the normal and impaired groups was 6.1 vs 5.7\xa0months (P\xa0=\xa00.698) and 16.1 vs 18.5\xa0months (P\xa0=\xa00.638), respectively.\n\n\nCONCLUSIONS\nS-1 plus oxaliplatin in advanced gastric cancer patients with impaired renal function appears safe and has demonstrated efficacy given appropriate dose modification.