Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2013 Dec 12;8(12):e82798.
doi: 10.1371/journal.pone.0082798. eCollection 2013.

S-1-based chemotherapy versus capecitabine-based chemotherapy as first-line treatment for advanced gastric carcinoma: a meta-analysis

Ming-ming He  1 , Wen-jing Wu  1 , Feng Wang  1 , Zhi-qiang Wang  1 , Dong-sheng Zhang  1 , Hui-yan Luo  1 , Miao-zhen Qiu  1 , Feng-Hua Wang  1 , Chao Ren  1 , Zhao-Lei Zeng  1 , Rui-hua Xu  1
Affiliations
Meta-Analysis

S-1-based chemotherapy versus capecitabine-based chemotherapy as first-line treatment for advanced gastric carcinoma: a meta-analysis

Ming-ming He et al. PLoS One. .

Abstract

Background: Although both oral fluoropyrimidines were reported effective and safe, doubts exist about whether S-1 or capecitabine is more advantageous in advanced gastric carcinoma (AGC). Herein, we performed a meta-analysis to comprehensively compare the efficacy and safety of S-1-based chemotherapy versus capecitabine-based chemotherapy as first-line treatment for AGC.

Methods: PubMed/Medline, EmBase, Cochrane library, and China National Knowledge Infrastructure databases were searched for articles comparing S-1-based chemotherapy to capecitabine-based chemotherapy for AGC. Primary outcomes were overall response rate (ORR), time to progression (TTP), overall survival (OS), progression-free probability, and survival probability. Secondary outcomes were toxicities. Fixed-effects model were used and all the results were confirmed by random-effects model.

Results: Five randomized controlled trials and five cohort studies with 821 patients were included. We found equivalent ORR (38.3% vs. 39.1%, odds ratio [OR] 0.92, 95% confidence interval [CI] 0.69-1.24, P = 0.59), TTP (harzad ratio [HR] 0.98, 95% CI 0.82-1.16, P = 0.79), OS (HR 0.99, 95% CI 0.87-1.13, P = 0.91), progression-free probability (3-month OR 1.02, 95% CI 0.62-1.68, P = 0.94; 6-month OR 1.34, 95% CI 0.88-2.04, P = 0.18) and survival probability (0.5-year OR 0.90, 95% CI 0.61-1.31, P =0.57; 1-year OR 0.97, 95% CI 0.70- 1.33, P = 0.84; 2-year OR 1.15, 95% CI 0.61-2.17, P = 0.66). Equivalent grade 3 to 4 hematological and non-hematological toxicities were found except hand-foot syndrome was less prominent in S-1-based chemotherapy (0.3% vs. 5.9%, OR 0.19, 95% CI 0.06-0.56, P = 0.003). There're no significant heterogeneity and publication bias. Cumulative analysis found stable time-dependent trend. Consistent results stratified by study design, age, regimen, cycle, country were observed.

Conclusion: S-1-based chemotherapy was associated with non-inferior antitumor efficacy and better safety profile, compared with capecitabine-based therapy. We recommended S-1 and capecitabine can be used interchangeably for AGC, at least in Asia.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Meta-analysis profile summarizing trial flow.
Figure 2
Figure 2. Meta-analysis of overall response rate for S-1-based chemotherapy compared with capecitabine-based chemotherapy.
Figure 3
Figure 3. Meta-analysis of time to progression for S-1-based chemotherapy compared with capecitabine-based chemotherapy.
Figure 4
Figure 4. Meta-analysis of 3-month, 6-month progression-free probability for S-1-based chemotherapy compared with capecitabine-based chemotherapy.
Figure 5
Figure 5. Meta-analysis of overall survival for S-1-based chemotherapy compared with capecitabine-based chemotherapy.
Figure 6
Figure 6. Meta-analysis of 0.5-year, 1-year, and 2-year survival probability for S-1-based chemotherapy compared with capecitabine-based chemotherapy.
Figure 7
Figure 7. Begg’s funnel plots.
Figure 8
Figure 8. Cumulative meta-analysis to sort out the time-tendency of outcomes.
See this image and copyright information in PMC

References

    1. Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24: 2137-2150. doi:10.1200/JCO.2005.05.2308. PubMed: 16682732. - DOI - PubMed
    1. Chen XL, Chen XZ, Yang C, Liao YB, Li H, et al. (2013) Docetaxel, Cisplatin and Fluorouracil (DCF) Regimen Compared with Non-Taxane-Containing Palliative Chemotherapy for Gastric Carcinoma: A Systematic Review and Meta-Analysis. PLoS One 8: e60320. doi:10.1371/journal.pone.0060320. - DOI - PMC - PubMed
    1. Choi KS, Jun JK, Park EC, Park S, Jung KW et al. (2012) Performance of Different Gastric Cancer Screening Methods in Korea: A Population-Based Study. PLOS ONE 7: e50041. doi:10.1371/journal.pone.0050041. PubMed: 23209638. - DOI - PMC - PubMed
    1. Tsai JY, Safran H (2003) Status of treatment for advanced gastric carcinoma. Curr Oncol Rep 5: 210-218. doi:10.1007/s11912-003-0112-9. PubMed: 12667418. - DOI - PubMed
    1. Van Cutsem E, Van de Velde C, Roth A, Lordick F, Köhne C-H et al. (2008) Expert opinion on management of gastric and gastro-oesophageal junction adenocarcinoma on behalf of the European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group. Eur J Cancer 44: 182-194. doi:10.1016/j.ejca.2007.11.001. PubMed: 18093827. - DOI - PubMed

Publication types

MeSH terms