Consecutive use of S-1 plus irinotecan is not recommended as second-line treatment in patients with advanced gastric cancer who are refractory to S-1-based first-line chemotherapy, a new study published online ahead of print in the journal Annals of Oncology has shown.

S-1 is an oral fluoropyrimidine used in combination with cisplatin for the first-line treatment of patients with advanced gastric cancer in Japan.

For the study, researchers sought to evaluate whether the consecutive use of S-1 plus irinotecan improves survival versus irinotecan alone as second-line treatment for advanced gastric cancer.

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Researchers enrolled 304 patients and randomly assigned them to receive S-1 40-60 mg/m2 orally on days 1 to 14 plus irinotecan 150 mg/m2 IV on day 1 of a 21-day cycle or irinotecan alone on day 1 of a 14-day cycle.

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Results showed that median overall survival was 8.8 months for S-1 plus irinotecan compared with 9.5 months for irinotecan alone (HR for death = 0.99; 95% CI: 0.78, 1.25; P=0.92).