A meta-analysis of efficacy and safety of S-1 monotherapy or combination therapy as first-line treatment in metastatic colorectal cancer
International Journal of Colorectal Disease, ISSN: 1432-1262, Vol: 35, Issue: 8, Page: 1567-1574
2020
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Article Description
Purpose: To compare the efficacy and safety profile of S-1-based versus non-S-1-based chemotherapy as first-line treatment in mCRC. Methods: Relevant randomized controlled trials (RCTs) were obtained from PubMed, Embase, and Ovid databases and the Cochrane library from database set up in May 2018. The RCTs of S-1-based monotherapy or combination therapy as first-line treatment were selected. The impact of S-1-based chemotherapy on progression-free survival (PFS) and overall survival (OS) was assessed by pooling data via RevMan 5.3. Results: Meta-analysis of 10 RCTs showed that S-1-based chemotherapy significantly improved PFS (HR 0.90, 95% CI 0.84–0.97, P = 0.006). In subgroup analysis, there was a statistically significant increase in PFS when S-1-based chemotherapy was compared with 5-FU-based (HR 0.92, 95% CI 0.84–1.00, P = 0.04) or capecitabine-based chemotherapy (HR 0.85, 95% CI 0.73–0.99, P = 0.04). The meta-analysis of OS (HR 0.95, 95% CI 0.86–1.05, P = 0.36), overall response rate (ORR) (HR 0.99, 95% CI 0.84–1.17, P = 0.90), and disease control rate (DCR) (HR 1.61, 95% CI 0.87–3.00, P = 0.13) showed no statistical significance between S-1-based and non-S-1-based chemotherapy. The statistically significant differences in the meta-analysis indicated less incidence of graded 3–4 leucopenia (OR = 0.30, 95% CI 0.13–0.71, P = 0.006) and hand–foot syndrome (HFS) (OR = 0.24, 95% CI 0.10–0.58, P = 0.001) in the S-1-based chemotherapy, and there was no statistically significant difference for other adverse events. Conclusions: S-1-based chemotherapy in mono or combined therapy was an attractive alternative to standard first-line regimen for patients of mCRC.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85084430131&origin=inward; http://dx.doi.org/10.1007/s00384-020-03606-x; http://www.ncbi.nlm.nih.gov/pubmed/32394076; https://link.springer.com/10.1007/s00384-020-03606-x; https://dx.doi.org/10.1007/s00384-020-03606-x; https://link.springer.com/article/10.1007/s00384-020-03606-x
Springer Science and Business Media LLC
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