S-1 based doublet as an adjuvant chemotherapy for curatively resected stage III gastric cancer: Results from the randomized phase III POST trial

Choong Kun Lee, Minkyu Jung, Hyo Song Kim, Inkyung Jung, Dong Bok Shin, Seok Yun Kang, Dae Young Zang, Ki Hyang Kim, Moon Hee Lee, Bong Seog Kim, Kyung Hee Lee, Jae Ho Cheong, Woo Jin Hyung, Sung Hoon Noh, Hyun Cheol Chung, Sun Young Rha

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Abstract

Purpose We conducted a randomized, multicenter, phase III trial to compare S-1 plus docetaxel (DS) with S-1 plus cisplatin (SP) as adjuvant chemotherapy for stage III gastric cancer patients. Materials and Methods Stage III gastric cancer patients who had received curative gastrectomy with D2 lymphadenectomy were randomized into equal groups to receive adjuvant chemotherapy of eight cycles of DS (S-1 70 mg/m 2 /day on days 1-14 plus docetaxel 35 mg/m 2 on days 1 and 8) every 3 weeks or SP (S-1 70 mg/m 2 /day on days 1-14 plus cisplatin 60 mg/m 2 on day 1) every 3 weeks. The primary endpoint was 3-year disease-free survival (DFS) rate. Results Between November 2010 and July 2013, 153 patients (75 patients to DS and 78 patients to SP) were enrolled from 8 institutions in Korea. After the capecitabine plus oxaliplatin was approved based on the CLASSIC study, it was decided to close the study early. With a median follow-up duration of 56.9 months, the 3-year DFS rate between two groups was not significantly different (49.14% in DS group vs. 52.5% in SP group). The most common grade 3-4 adverse event was neutropenia (42.7% in DS and 38.5% in SP, p=0.351). SP group had more grade 3-4 anemia (1.3% vs. 11.5%, p=0.037), whereas grade 3-4 hand-foot syndrome (4.1% vs. 0%, p=0.025) and mucositis (10.7% vs. 2.6%, p=0.001) were more common in DS group. Fifty-one patients (68%) in DS group and 52 (66.7%) in SP group finished planned treatment. Conclusion Our findings suggest that SP or DS is an effective and tolerable option for patients with curatively resected stage III gastric cancer.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalCancer Research and Treatment
Volume51
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Lee, C. K., Jung, M., Kim, H. S., Jung, I., Shin, D. B., Kang, S. Y., Zang, D. Y., Kim, K. H., Lee, M. H., Kim, B. S., Lee, K. H., Cheong, J. H., Hyung, W. J., Noh, S. H., Chung, H. C., & Rha, S. Y. (2019). S-1 based doublet as an adjuvant chemotherapy for curatively resected stage III gastric cancer: Results from the randomized phase III POST trial. Cancer Research and Treatment, 51(1), 1-11. https://doi.org/10.4143/crt.2018.028