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
. 2019 Jun;98(23):e15999.
doi: 10.1097/MD.0000000000015999.

Efficacy and safety assessment of S-1-based regimens comparing to intravenous fluorouracil-based ones in Asian patients with metastatic colorectal carcinoma: A system review and meta-analysis

Jianxin Chen  1 , Junhui Wang  2
Affiliations
Meta-Analysis

Efficacy and safety assessment of S-1-based regimens comparing to intravenous fluorouracil-based ones in Asian patients with metastatic colorectal carcinoma: A system review and meta-analysis

Jianxin Chen et al. Medicine (Baltimore). 2019 Jun.

Abstract

Background: We performed the present systematic review and meta-analysis to evaluate the efficacy and safety for S-1-based regimens comparing to intravenous fluorouracil-based ones in Asian patients with metastatic colorectal carcinoma (mCRC).

Methods: Eligible prospective and controlled randomized clinical trials (RCT) were included, of which data were extracted by inclusion criteria and exclusion ones. Odds ratio (OR) and Hazard ratio (HR) of outcomes including objective response rate (ORR), disease control rate (DCR), progressive-free survival (PFS), overall survival (OS), and adverse events (AEs) were explored for the final analysis between the 2 groups.

Results: A total of 23 eligible prospective, controlled RCTs including 2269 patients were enrolled for the pooled analysis. With the meta-analysis of available data, the results of the present research showed that there was no statistical difference on short-term efficacy including ORR (HR = 0.85, 95% CI: 0.71-1.01; P = .07) or DCR (HR = 0.88, 95% CI: 0.69-1.11; P = .27), as well as long-term efficacy including PFS (HR = 1.00, 95% CI: 0.90-1.11; P = .98) or OS (HR = 0.95, 95% CI: 0.82-1.10; P = .50). In addition, the incidences of AEs including leucopenia, neutropenia, and vomiting were statistically lower in S-1-based regimens comparing to intravenous fluorouracil-based ones, regardless of all grade or high grade (all P <.05). However, there were no significant differences detected among other AEs including anemia, thrombocytopenia, increased alanine aminotransferase concentration, stomatitis, anorexia, diarrhea, hand-foot syndrome (HFS), or sensory neuropathy among the 2 groups (all P >.05).

Conclusions: The present meta-analysis revealed that S-1-based regimens might be associated with comparable efficacy, as well as lower risk of leucopenia, neutropenia, and vomiting at all/high grade comparing to intravenous fluorouracil-based ones in Asian patients with mCRC.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study selection procedure with PRISMA flow diagram. PRISMA = preferred reporting items for systematic reviews and meta-analyses.
Figure 2
Figure 2
Risk of bias summary: review authors’ judgments about each risk of bias item for each included study.
Figure 3
Figure 3
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages among all included studies.
Figure 4
Figure 4
Forest plot of the odds ratio of ORR with their confidence intervals by subgroups combined with oxaliplatin or irinotecan. ORR = objective response rate.
Figure 5
Figure 5
Forest plot of the odds ratio of DCR with their confidence intervals by subgroups combined with oxaliplatin or irinotecan. DCR = disease control rate.
Figure 6
Figure 6
Forest plot of the HR of PFS with their confidence intervals. HR = hazard ratio, PFS = progressive-free survival.
Figure 7
Figure 7
Forest plot of the HR of OS with their confidence intervals. HR = hazard ratio, OS = overall survival.
Figure 8
Figure 8
Funnel plot for publication bias with ORR. ORR = objective response rate.
See this image and copyright information in PMC

References

    1. Mei Z, Shao YW, Lin P, et al. Smad4 and nf1 mutations as potential biomarkers for poor prognosis to cetuximab-based therapy in chinese metastatic colorectal cancer patients. BMC cancer 2018;18:479. - PMC - PubMed
    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in globocan 2012. Int J Cancer 2015;136:E359–386. - PubMed
    1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in china, 2015. CA Cancer J Clin 2016;66:115–32. - PubMed
    1. Yoshino T, Arnold D, Taniguchi H, et al. Pan-asian adapted esmo consensus guidelines for the management of patients with metastatic colorectal cancer: a jsmo-esmo initiative endorsed by csco, kaco, mos, sso and tos. Ann Oncol Off J Eur Soc Med Oncol 2018;29:44–70. - PubMed
    1. Nishina T, Azuma M, Nishikawa K, et al. Early tumor shrinkage and depth of response in patients with advanced gastric cancer: a retrospective analysis of a randomized phase iii study of first-line s-1 plus oxaliplatin vs. S-1 plus cisplatin. Gastric Cancer 2019;22:138–46. - PubMed

MeSH terms