Association of renal function with the safety and efficacy of cisplatin plus S-1 therapy and docetaxel plus cisplatin plus S-1 therapy in patients with advanced gastric cancer: an exploratory analysis of JCOG1013.

Autor:	Hironaka S; Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Yufu, Japan., Sadachi R; Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan., Machida N; Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan., Iwasa S; Division of Gastrointestinal Medical Oncology, National Cancer Centre Hospital, Tokyo, Japan., Yamada Y; Comprehensive Cancer Center, National Center for Global Health and Medicine, Tokyo, Japan.; Department of Medical Oncology, Hamamatsu University School of Medicine, Hamamatsu, Japan., Sasako M; Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan., Yoshikawa T; Department of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan., Boku N; Division of Gastrointestinal Medical Oncology, National Cancer Centre Hospital, Tokyo, Japan., Terashima M; Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Jazyk:	angličtina
Zdroj:	Japanese journal of clinical oncology [Jpn J Clin Oncol] 2022 Jan 03; Vol. 52 (1), pp. 14-23.
DOI:	10.1093/jjco/hyab160
Abstrakt:	Background: Although cisplatin and 5-chloro-2,4-dihydropyrimidine (dihydropyrimidine dehydrogenase inhibitor contained in S-1) are excreted into the urine, it remains unknown how creatinine clearance (CrCl) affects the safety and efficacy of cisplatin plus S-1 and docetaxel plus cisplatin plus S-1 in patients with advanced gastric cancer. Methods: Among the 741 participants in JCOG1013 comparing cisplatin plus S-1 with docetaxel plus cisplatin plus S-1, 723 with serum creatinine levels ≤1.2 mg/dL were categorized into A1 (CrCl ≥ 80 mL/min), A2 (60 ≤ CrCl <80) and A3 (CrCl < 60) in the cisplatin plus S-1 arm and similarly B1, B2 and B3 in the docetaxel plus cisplatin plus S-1 arm. The initial dose modification by CrCl was pre-specified in the docetaxel plus cisplatin plus S-1 arm but not in the cisplatin plus S-1 arm. Results: The numbers of patients categorized as A1/A2/A3 and B1/B2/B3 were 169/136/57 and 170/138/53, respectively. In the cisplatin plus S-1 arm, a lower CrCl was associated with higher incidences of grade 4 leukopenia (P = 0.006), neutropenia (P = 0.002), and grade 3/4 anorexia (P = 0.004) and febrile neutropenia (P = 0.049), whereas there was no association in the docetaxel plus cisplatin plus S-1 arm. No significant differences were observed according to CrCl in the overall survival [median: 15.4/15.5/15.4 months in A1/A2/A3 (P = 0.886) and 15.3/13.7/13.7 months in B1/B2/B3 (P = 0.719)], progression-free survival [median: 7.1/6.8/6.2 months in A1/A2/A3 (P = 0.884) and 7.5/7.2/7.8 months in B1/B2/B3 (P = 0.851)] and response rates [58.9/57.8/46.9% in A1/A2/A3 (P = 0.311) and 62.0/61.5/51.5% in B1/B2/B3 (P = 0.362)]. Conclusions: Renal impairment was associated with severe adverse events in cisplatin plus S-1 therapy but not with the efficacy in cisplatin plus S-1 and docetaxel plus cisplatin plus S-1 therapy. (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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