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S-1 monotherapy versus S-1 combination therapy in gemcitabine-refractory advanced pancreatic cancer: A meta-analysis (PRISMA) of randomized control trials.

Abstract Pancreatic cancer (PC) is one of the most lethal digestive system tumors. Most new cases are diagnosed based on metastasis or local aggression and are known as "advanced PC." Recently, studies investigating S-1 have indicated that it has a better clinical curative effect on PC. We conducted a meta-analysis to evaluate the efficacy and safety of S-1 monotherapy compared with S-1 combination regimens in patients with gemcitabine (GEM)-refractory PC.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28746215
OWN - NLM
STAT- MEDLINE
DA  - 20170726
DCOM- 20170807
LR  - 20170807
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - S-1 monotherapy versus S-1 combination therapy in gemcitabine-refractory advanced
      pancreatic cancer: A meta-analysis (PRISMA) of randomized control trials.
PG  - e7611
LID - 10.1097/MD.0000000000007611 [doi]
AB  - BACKGROUND: Pancreatic cancer (PC) is one of the most lethal digestive system
      tumors. Most new cases are diagnosed based on metastasis or local aggression and 
      are known as "advanced PC." Recently, studies investigating S-1 have indicated
      that it has a better clinical curative effect on PC. We conducted a meta-analysis
      to evaluate the efficacy and safety of S-1 monotherapy compared with S-1
      combination regimens in patients with gemcitabine (GEM)-refractory PC. METHODS:
      Trials published between 1978 and 2016 were identified by an electronic search of
      public databases (Medline, Embase, and the Cochrane Library). All prospective
      studies were independently identified by 2 authors for inclusion. The response
      rate (RR), progression-free and overall survival (PFS and OS, respectively), and 
      the primary toxicities were extracted for the meta-analysis. RESULTS: Four
      randomized controlled trials consisting of 623 patients were included in the
      analysis, among which 315 patients underwent S-1 monotherapy and 308 patients
      underwent S-1 combination therapy. The pooled data showed a significantly higher 
      response rate and longer PFS in the S-1 combination group than in the S-1
      monotherapy group (RR, 1.75; 95% confidence interval [CI], 1.19-2.57; P = .005
      and hazard ration [HR], 0.75; 95% CI, 0.62-0.91; P = .005). There were no
      significant differences in OS or adverse events. CONCLUSIONS: Compared with the
      S-1 monotherapy group, the S-1 combination group had a higher response rate and
      longer PFS. Both groups had few adverse events, which were balanced between the
      groups. The subgroup analysis suggested that S-1 combination regimens with
      leucovorin or irinotecan (CPT-11) provided promising efficacy. These promising
      combination regimens should be considered for patients with advanced PC who
      choose S-1 as their second-line therapy.
FAU - Zhong, Sheng
AU  - Zhong S
AD  - aDepartment of Neurosurgery, the First Hospital of Jilin University bClinical
      College, Jilin University, Changchun, China cDepartment of the Radiotherapy,
      Hebei University Affiliated Hospital, Baoding dPublic Health College, Jilin
      University eBasic Medical College, Qiqihar Medical University, Qiqihar fRadiology
      Department, Jixi Mining General Hospital, Jixi gHepatopancreatobiliary Medicine
      Department, the First Hospital of Jilin University, Changchun, China.
FAU - Qie, Shuai
AU  - Qie S
FAU - Yang, Liu
AU  - Yang L
FAU - Yan, Qi
AU  - Yan Q
FAU - Ge, Linna
AU  - Ge L
FAU - Wang, Zhongfeng
AU  - Wang Z
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antimetabolites, Antineoplastic)
RN  - 0 (Drug Combinations)
RN  - 0W860991D6 (Deoxycytidine)
RN  - 150863-82-4 (S 1 (combination))
RN  - 1548R74NSZ (Tegafur)
RN  - 5VT6420TIG (Oxonic Acid)
RN  - B76N6SBZ8R (gemcitabine)
SB  - AIM
SB  - IM
MH  - Antimetabolites, Antineoplastic/*administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols
MH  - Deoxycytidine/administration & dosage/*analogs & derivatives
MH  - Drug Combinations
MH  - Drug Resistance, Neoplasm
MH  - Humans
MH  - Oxonic Acid/*administration & dosage
MH  - Pancreatic Neoplasms/*drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Tegafur/*administration & dosage
EDAT- 2017/07/27 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007611 [doi]
AID - 00005792-201707280-00046 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7611. doi: 10.1097/MD.0000000000007611.