Oxaliplatin plus S-1 is as effective as cisplatin plus S-1 for the treatment of advanced gastric cancer in chemotherapy-naive patients and is associated with fewer serious adverse events, a noninferiority trial has shown.
The randomized, open-label, phase III study in 685 patients found that oxaliplatin plus S-1 achieved noninferiority in progression-free survival, compared with cisplatin plus S-1 (5.5 versus 5.4 months; hazard ratio, 1.004; 95% confidence interval, 0.840-1.199), with a similar duration of overall survival, according to a paper published online Oct. 14 (Ann. Oncol. 2014 [doi:10.1093/annonc/mdu472]).
Researchers also observed significantly more cases of grade 3 or worse leukopenia, neutropenia, anemia, febrile neutropenia, hyponatremia, and sensory neuropathy among patients treated with cisplatin plus S-1.
“Renal function is likely impaired during treatment with a cisplatin-containing regimen, even when adequate hydration to prevent renal toxicity is provided, while oxaliplatin does not affect renal function [and] these were the probable reasons underlying the favorable results of SOX [oxaliplatin plus S-1] in elderly patients or patients with renal dysfunction,” wrote Dr. Yasuhide Yamada of the National Cancer Center Hospital, Tokyo, and colleagues.
The study was funded by Yakult Honsha. Some authors declared honoraria, travel grants, consultancies, and funding from the study sponsor and other pharmaceutical companies.