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Int J Clin Oncol. 2017 Apr;22(2):274-282. doi: 10.1007/s10147-016-1067-9. Epub 2016 Dec 5.

Feasibility of adjuvant chemotherapy with S-1 plus carboplatin followed by single-agent maintenance therapy with S-1 for completely resected non-small-cell lung cancer: results of the Setouchi Lung Cancer Group Study 1001.

Author information

1
Department of Thoracic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan. no7869@kchnet.or.jp.
2
Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto, Japan.
3
Division of Thoracic Surgery, Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Japan.
4
Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Japan.
5
Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifuku-cho, Kita-ku, Okayama, Japan.
6
Department of Thoracic Surgery, Shikoku Cancer Center, 160 Minamiumemoto, Matsuyama, Japan.
7
Department of General Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Japan.
8
Department of Thoracic Surgery, Iwakuni Clinical Center, 1-1-1 Atagomachi, Iwakuni, Japan.
9
Department of Thoracic Surgery, Kure Medical Center/Chugoku Cancer Center, 3-1 Aoyamacho, Kure, Japan.
10
Department of Thoracic, Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
11
Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Japan.
12
Department of Hematology and Oncology, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
13
Division of Molecular Medicine, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan.
14
Tokai Central Hospital, 4-6-2 Soharahigashijima, Kakamigahara, Japan.
15
Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.

Abstract

BACKGROUND:

This multicenter study evaluated the feasibility of novel adjuvant chemotherapy with S-1 plus carboplatin followed by single-agent, long-term maintenance with S-1 in patients with completely resected stage II-IIIA non-small-cell lung cancer (NSCLC).

METHODS:

Patients received four cycles of S-1 (80 mg/m2/day for 2 weeks, followed by 2 weeks rest) plus carboplatin (area under the curve 5, day 1) followed by S-1 (80 mg/m2/day for 2 weeks, followed by a 1-week rest). Patients unable to continue S-1 plus carboplatin because of severe toxicity converted to single-agent S-1 maintenance. The duration of adjuvant chemotherapy was 10 months in both situations. The primary endpoint was feasibility, defined as the proportion of patients who completed four cycles of S-1 plus carboplatin and single-agent S-1 maintenance for 10 months. The treatment completion rate was determined; treatment was considered feasible if the lower 90% confidence interval (CI) was ≥50%.

RESULTS:

Eighty-nine patients were enrolled, of whom 87 were eligible and assessable. Seventy-eight patients (89.7%) completed four cycles of S-1 plus carboplatin and 55 (63.2%) completed the following S-1 maintenance therapy for a total of 10 months. The treatment completion rate was 63.2% (90% CI, 54.4-71.2%), indicating feasibility. There were no treatment-related deaths. Grade 3/4 toxicities included neutropenia (13.8%), thrombocytopenia (11.5%), and anorexia (4.6%). The 2-year relapse-free survival rate was 59.8%.

CONCLUSIONS:

We concluded that adjuvant chemotherapy with S-1 plus carboplatin followed by single-agent maintenance therapy with S-1 is feasible and tolerable in patients with completely resected NSCLC.

CLINICAL REGISTRATION NUMBER:

UMIN000005041.

KEYWORDS:

Adjuvant chemotherapy; Carboplatin; Maintenance therapy; Non-small-cell lung cancer; S-1

PMID:
27921177
DOI:
10.1007/s10147-016-1067-9
[Indexed for MEDLINE]

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