Tohoku J. Exp. Med., 2017 January, 241(1)

Meta-analysis Exploring the Effectiveness of S-1-Based Chemotherapy for Advanced Non-Small Cell Lung Cancer

XIN SUN,¹ LI SUN,¹ SHU-LING ZHANG,¹ ZHI-CHENG XIONG,¹ JIE-TAO MA¹ and CHENG-BO HAN¹

¹Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China

S-1 is a new oral fluoropyrimidine formulation that comprises tegafur, 5-chloro-2,4-dihydroxypyridine, and potassium oxonate. S-1 is designed to enhance antitumor activity and to reduce gastrointestinal toxicity. Several studies have demonstrated that both S-1 monotherapy and S-1 combination regimens showed encouraging efficacies and mild toxicities in the treatment of lung squamous cell carcinoma and adenocarcinoma. However, it is unclear whether S-1 can be used as standard care in advanced non-small cell lung cancer (NSCLC). The purpose of this meta-analysis was to assess the efficacy and safety of S-1-based chemotherapy, compared with standard chemotherapy, in patients with locally advanced or metastatic NSCLC. Thirteen randomized controlled trials (RCTs) involving 2,134 patients with a similar ratio of different pathological types were included. In first-line or second-line chemotherapy, compared with standard chemotherapy, S-1-based chemotherapy showed similar efficacy in terms of median overall survival (mOS), median progression free survival (mPFS), and objective response rate (ORR) (all P > 0.1), and significantly reduced the incidence of grade ≥ 3 hematological toxicities. In patients with locally advanced NSCLC receiving concurrent chemoradiotherapy, compared with standard chemoradiotherapy, significantly improved survival in the S-1-based chemotherapy was noted in terms of mOS and mPFS (risk radio [RR] = 1.289, P = 0.009; RR = 1.289, P = 0.000, respectively) with lower incidence of grade ≥ 3 neutropenia (RR = 0.453, P = 0.000). The present meta-analysis demonstrates that S-1-based chemotherapy shows similar benefits in advanced NSCLC and improves survival in locally advanced NSCLC, compared with standard treatment.

keywords —— chemotherapy; chemoradiotherapy; meta-analysis; non-small cell lung cancer; S-1

© 2017 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2017, 241, 1-11

Correspondence: Cheng-Bo HAN M.D., Ph.D., Department of Oncology, Shengjing Hospital of China Medical University, Shenyang 110022, China.

e-mail: hanchengbo@sj-hospital.org