Oxaliplatin Effective as Cisplatin for Treatment-Naive Gastric Cancer

the Cancer Therapy Advisor take:

According to a new study published in the journal Annals of Oncology, S-1, a novel oral dihydropyrimidine dehydrogenase inhibitory fluoropyrimidine, plus oxaliplatin (SOX) is as effective as S-1 plus cisplatin (CS) for the first-line treatment of patients with advanced gastric cancer and is well tolerated.

For the open-label, multicenter phase 3 study, 685 patients with newly diagnosed gastric cancer were randomly assigned to receive S-1 120mg/day for 2 weeks plus oxaliplatin 100mg/m2 on day 1 every 3 weeks or S-1 120mg/day for 3 weeks plus cisplatin 60mg/m2 on day 8 every 5 weeks.

Results showed that in the per-protocol population, the median progression-free survival was 5.5 and 5.4 months for SOX and CS, respectively (HR = 1.004; 95% CI: 0.840 - 1.199). The median overall survival for SOX was 14.1 months compared with 13.1 months for CS (HR = 0.958; 95% CI: 0.803 - 1.142).

In the intention-to-treat population, the hazard ratio for progression-free survival was 0.979 (95% CI: 0.821 - 1.167) and for overall survival was 0.934 (95% CI: 0.786 - 1.108). Patients receiving CS experienced grade 3 or higher neutropenia, anemia, hyponatremia, and febrile neutropenia more often than those receiving SOX, while those in the the SOX arm experienced grade 3 or higher sensorty neuropathy more often.

The findings suggest that SOX is noninferior to CS for patients with advanced gastric cancer, and therefore, SOX can be used in place of CS.