Department of Respirology (B2), Graduate School of Medicine, Chiba University, Chiba, Japan.
J Thorac Oncol. 2011 Jan;6(1):156-60. doi: 10.1097/JTO.0b013e3181f7c76a.
Standard second-line chemotherapies for non-small cell lung cancer (NSCLC) have been established but have limited clinical relevance. S-1 is a recently developed agent with potential activity against NSCLC.
Patients with confirmed NSCLC recurrence after previous single- or two-regimen chemotherapy with platinum, performance status of 0 to 1, adequate organ functions, and measurable lesions were treated with S-1 (60 mg/m/d, twice a day) on days 1 to 14 and gemcitabine (1000 mg/m) on days 8 and 15, which were repeated every 3 weeks until tumor progression.
Treatment was administered for a median of 4 courses (range, 1-13) over a median of 125-day period in 34 patients. The overall response rate was 23.5% (no complete response and eight partial response; 95% confidence interval: 9.1-38.0%). The median progression-free and overall survival times were 6.6 and 19.9 months, respectively. The 1- and 2-year survival rates were 58.8 and 30.9%, respectively. Toxicity was mild during the entire treatment period, except for three grade 3 interstitial pneumonia.
The primary end point was met with the relatively high overall response rate. Randomized phase III studies for elucidating survival outcome of the regimen are warranted.
非小细胞肺癌(NSCLC)的标准二线化疗方案已经确立,但临床相关性有限。S-1 是一种新开发的药物,对 NSCLC 具有潜在的活性。
对先前接受过铂类单药或两药化疗且复发的 NSCLC 患者,根据体能状态(PS)评分 0-1、器官功能充足、有可测量病灶,给予 S-1(60mg/m/d,每天两次)治疗,第 1-14 天;吉西他滨(1000mg/m)治疗,第 8 和 15 天,每 3 周重复,直至肿瘤进展。
34 例患者中位治疗 4 个疗程(范围,1-13),中位治疗时间为 125 天。总缓解率为 23.5%(无完全缓解,8 例部分缓解;95%置信区间:9.1-38.0%)。中位无进展生存期和总生存期分别为 6.6 和 19.9 个月。1 年和 2 年生存率分别为 58.8%和 30.9%。除 3 例 3 级间质性肺炎外,整个治疗期间毒性较轻。
主要终点达到了较高的总缓解率。需要进行随机 III 期研究以阐明该方案的生存结果。