M Shimoda1, K Kubota, T Shimizu, M Katoh. 1. Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
Abstract
BACKGROUND: Randomized studies of adjuvant chemotherapy using gemcitabine suggest a survival benefitafter resection of pancreatic cancer. S-1 has also been shown to prolong survival in patients with unresectable pancreatic cancer. This study compared the effects of adjuvant chemotherapy with S-1 or gemcitabineafter resection of pancreatic cancer in a randomized trial. METHODS:Patients who had undergone resection of pancreatic cancer were registered in this randomized clinical trial. The primary endpoint was disease-free survival (DFS). Expression levels of thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) mRNAs in cancer tissues were measured as indicators of fluoropyrimidine sensitivity. RESULTS: Of 57 patients registered, 29 were allocated to the S-1 group and 28 togemcitabine. DFS tended to be better with S-1 (median 14·6 (90 per cent c.i. 8·8 to 28·4) months versus 10·5 (7·0 to 28·4) months in the gemcitabine group; P = 0·188), with a similar pattern for overall survival: 21·5 (95 per cent c.i. 14·4 to 42·3) and 18·0 (13·3 to 42·8) months respectively (P = 0·293). When patients were divided into subgroups based on high or low DPD and TS expression, those with a DPD level below the median of 0·88 or a TS level of at least 2·00 had a significant prolongation of DFS after S-1 treatment compared with gemcitabine (P = 0·008 and P = 0·035 respectively). CONCLUSION: Overall, S-1 did not improve DFS compared with gemcitabine after pancreatic cancer resection, but there seemed to be a DFS advantage in patients with low expression of DPD or high expression of TS. Reference number: UMIN000009118 (http://www.umin.ac.jp/ctr/).
RCT Entities:
BACKGROUND: Randomized studies of adjuvant chemotherapy using gemcitabine suggest a survival benefit after resection of pancreatic cancer. S-1 has also been shown to prolong survival in patients with unresectable pancreatic cancer. This study compared the effects of adjuvant chemotherapy with S-1 or gemcitabine after resection of pancreatic cancer in a randomized trial. METHODS:Patients who had undergone resection of pancreatic cancer were registered in this randomized clinical trial. The primary endpoint was disease-free survival (DFS). Expression levels of thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) mRNAs in cancer tissues were measured as indicators of fluoropyrimidine sensitivity. RESULTS: Of 57 patients registered, 29 were allocated to the S-1 group and 28 to gemcitabine. DFS tended to be better with S-1 (median 14·6 (90 per cent c.i. 8·8 to 28·4) months versus 10·5 (7·0 to 28·4) months in the gemcitabine group; P = 0·188), with a similar pattern for overall survival: 21·5 (95 per cent c.i. 14·4 to 42·3) and 18·0 (13·3 to 42·8) months respectively (P = 0·293). When patients were divided into subgroups based on high or low DPD and TS expression, those with a DPD level below the median of 0·88 or a TS level of at least 2·00 had a significant prolongation of DFS after S-1 treatment compared with gemcitabine (P = 0·008 and P = 0·035 respectively). CONCLUSION: Overall, S-1 did not improve DFS compared with gemcitabine after pancreatic cancer resection, but there seemed to be a DFS advantage in patients with low expression of DPD or high expression of TS. Reference number: UMIN000009118 (http://www.umin.ac.jp/ctr/).
Authors: Woohyung Lee; Yoo-Seok Yoon; Ho-Seong Han; Jin Young Jang; Jai Young Cho; Woohyun Jung; Wooil Kwon; YoungRok Choi; Sun-Whe Kim Journal: World J Surg Date: 2017-02 Impact factor: 3.352
Authors: N O Elander; K Aughton; P Ghaneh; J P Neoptolemos; D H Palmer; T F Cox; F Campbell; E Costello; C M Halloran; J R Mackey; A G Scarfe; J W Valle; A C McDonald; R Carter; N C Tebbutt; D Goldstein; J Shannon; C Dervenis; B Glimelius; M Deakin; R M Charnley; Alan Anthoney; M M Lerch; J Mayerle; A Oláh; M W Büchler; W Greenhalf Journal: Br J Cancer Date: 2018-03-08 Impact factor: 7.640
Authors: Hamid A Bakshi; Mazhar S Al Zoubi; Faruck L Hakkim; Alaa A A Aljabali; Firas A Rabi; Amin A Hafiz; Khalid M Al-Batanyeh; Bahaa Al-Trad; Prawej Ansari; Mohamed M Nasef; Nitin B Charbe; Saurabh Satija; Meenu Mehta; Vijay Mishra; Gaurav Gupta; Salem Abobaker; Poonam Negi; Ibrahim M Azzouz; Ashref Ali K Dardouri; Harish Dureja; Parteek Prasher; Dinesh K Chellappan; Kamal Dua; Mateus Webba da Silva; Mohamed El Tanani; Paul A McCarron; Murtaza M Tambuwala Journal: Nutrients Date: 2020-06-26 Impact factor: 5.717