Living Longer With Two Instead of One

Advanced gastric cancer patients live longer with chemotherapy combination

(RxWiki News) Stomach or gastric cancer is not particularly common in this country, with just under 21,500 Americans diagnosed with it every year. Worldwide, though, it’s the second leading cause of cancer deaths. So finding new treatments are of international importance.

Combining two chemotherapy agents - fluoropyrimidine S-1 (Taiho) and docetaxel (Taxotere) – extends the lives of people with advanced gastric cancer.

"Ask your oncologist about the latest combination therapies."

These two drugs are used to treat a variety of cancers. Docetaxel, or Taxotere, is approved to treat breast, stomach and prostate cancers, as well as non-small cell lung cancer (NSCLC) and head and neck cancer.

Fluoropyrimidine S-1, sold under the brand name Taiho, is an oral medication used to treat non-small cell lung cancer and an array of solid tumors including gastric, colorectal, breast, cervical, and pancreatic cancers.

S-1 is currently the standard therapy for treating advanced or recurrent (returned) gastric cancer in East Asia.

The findings of phase III trial called START were inconclusive about adding docetaxel to S-1. These results were reported in 2011.

An independent biostatistician (professional who specializes in healthcare statistics) pointed out flaws in the original analysis and reviewed the study.

Dr. Kazuhiro Yoshida of Chiba University in Japan and colleagues presented an updated analysis at ESMO 2012, the European Society of Medical Oncology Congress in Vienna.

The median lifespan for the 635 patients with advanced stomach cancer was just under 12.5 months for those who had received the combination therapy group compared to 10.78 months in patients who were given S-1 alone.

"This combination is much better than S-1 monotherapy which is regarded as one of the standard therapies for metastatic gastric cancer in Japan," Dr. Yoshida said in an ESMO news release.

An earlier study called SPIRIT had shown that combining S-1 with cisplatin, a common platinum-based chemotherapy, is standard of care for gastric cancer in Asia.

Dr. Yoshida said that “our data for Japanese patients demonstrated more promising overall survival with a larger number of patients compared to the SPIRITS trial. These data will have an impact on daily practice for gastric cancer patients."

Prof Jean-Yves Douillard, chair of the ESMO Educational Committee, who was not involved in the study, said, “The START study, with the combination of docetaxel and S-1, might represent an alternative to the platinum-containing regimens widely used in Europe, but would need first to be evaluated in Caucasian populations to assess feasibility and tolerance at doses of docetaxel usually used in Europe, and not at lower doses as routinely done in Japan."

Research presented at medical conferences is considered preliminary before publication in a peer-reviewed journal.


Review Date: 
October 3, 2012