Cao Feiyi, Gu Cuiping, Hong Wei, Jin Ying
Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Department of Medical Oncology, Postgraduate training base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China.
Transl Cancer Res. 2024 Apr 30;13(4):2012-2025. doi: 10.21037/tcr-23-2019. Epub 2024 Apr 9.
Both domestically and worldwide, non-small cell lung cancer (NSCLC) remain the leading cause of cancer-related death. As a fluorouracil derivative, S-1 which shows good efficacy and with few adverse effects have been widely confirmed in many solid tumors that it can provide a glimmer of hope for advanced NSCLC patients. We performed a review to explore the results of previous clinical studies of S-1 monotherapy as well as combined therapy involving S-1 in patients with advanced NSCLC.
A literature search was conducted in Medline and PubMed databases using the keywords "S-1" AND "Advanced lung cancer" OR "Pharmacological mechanism".
A number of phase II clinical studies have reported on the favorable efficacy and excellent safety profiles of S-1 monotherapy in first-line or in posterior-line treatment for advanced NSCLC. In regard to S-1 in combination with chemotherapy, a number of phase II/III clinical studies have found the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) of these regimens are similar to or better than immunological monotherapy with fewer adverse effects. In the case of S-1 combined with anti-vascular therapy, a number of phase II single-arm clinical studies have found that S-1 combined with bevacizumab, anlotinib and apatinib in advanced NSCLC, exhibits higher antitumor activity, less adverse effects for patients with advanced NSCLC. A phase II single-arm clinical study of gefitinib combined with S-1 had the ORR of 85.7% in the first-line treatment of advanced NSCLC. As for the combination of S-1 and immunotherapy, preliminary results of a phase II retrospective clinical trial demonstrated that the ORR was significantly better with S-1 sequential after immune checkpoint inhibitors (ICIs) than with S-1 alone.
The findings indicate promising effectiveness and minimal toxicity with S-1 monotherapy and S-1 containing combined therapy in patients with advanced NSCLC to provide a potential treatment option for advanced NSCLC.
在国内和全球范围内，非小细胞肺癌（NSCLC）仍是癌症相关死亡的主要原因。作为一种氟尿嘧啶衍生物，S-1疗效良好且副作用较少，已在许多实体瘤中得到广泛证实，可为晚期NSCLC患者带来一线希望。我们进行了一项综述，以探讨先前关于S-1单药治疗以及S-1联合治疗晚期NSCLC患者的临床研究结果。
在Medline和PubMed数据库中使用关键词“S-1”和“晚期肺癌”或“药理机制”进行文献检索。
多项II期临床研究报告了S-1单药治疗在晚期NSCLC一线或后线治疗中的良好疗效和出色的安全性。关于S-1联合化疗，多项II/III期临床研究发现，这些方案的客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）与免疫单药治疗相似或更好，且副作用更少。在S-1联合抗血管治疗方面，多项II期单臂临床研究发现，S-1联合贝伐单抗、安罗替尼和阿帕替尼治疗晚期NSCLC，具有更高的抗肿瘤活性，对晚期NSCLC患者的副作用更少。一项吉非替尼联合S-1的II期单臂临床研究在晚期NSCLC一线治疗中的ORR为85.7%。至于S-1与免疫治疗的联合，一项II期回顾性临床试验的初步结果表明，免疫检查点抑制剂（ICI）后序贯S-1的ORR明显优于单独使用S-1。
研究结果表明，S-1单药治疗以及含S-1的联合治疗在晚期NSCLC患者中具有良好的有效性和最小的毒性，为晚期NSCLC提供了一种潜在的治疗选择。
