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A phase I study of S-1 with concurrent radiotherapy in elderly patients with locally advanced non-small cell lung cancer

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Summary

Background A phase I study was performed to evaluate dose-limiting toxicity and the recommended dose for the oral fluoropyrimidine S-1 administered concurrently with thoracic radiotherapy (TRT) in elderly (≥70 years of age) patients with locally advanced non-small cell lung cancer. Methods S-1 was administered on days 1 to 14 and 22 to 35 at oral doses of 65 or 80 mg m−2 day−1. TRT was administered in 2-Gy fractions five times weekly for a total dose of 60 Gy. Twelve previously untreated patients were treated with S-1 at 65 (n = 6) or 80 (n = 6) mg m−2 day−1. Results All patients completed the planned 60 Gy of TRT. Dose-limiting toxicity included pneumonitis (n = 2), infection (n = 1), and stomatitis (n = 1), each of grade 3, but each event was reversible. The recommended dose for S-1 was determined to be 80 mg m−2 day−1. No patient experienced toxicity of grade 4. The dose intensity of S-1 was well maintained and the combination of S-1 plus TRT was well tolerated overall. The overall response rate was 83.3 %, with a median survival time of 34.0 months. Conclusions Administration of S-1 at 80 mg m−2 day−1 on days 1 to 14 and 22 to 35 can be safely combined with concurrent TRT in elderly patients with locally advanced non-small cell lung cancer.

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References

  1. Blackstock AW, Govindan R (2007) Definitive chemoradiation for the treatment of locally advanced non small-cell lung cancer. J Clin Oncol 25:4146–4152

    Article  PubMed  CAS  Google Scholar 

  2. Movsas B, Scott C, Sause W et al (1999) The benefit of treatment intensification is age and histology-dependent in patients with locally advanced non-small cell lung cancer (nsclc): a quality-adjusted survival analysis of radiation therapy oncology group (rtog) chemoradiation studies. Int J Radiat Oncol Biol Phys 45:1143–1149

    Article  PubMed  CAS  Google Scholar 

  3. Atagi S, Kawahara M, Tamura T et al (2005) Standard thoracic radiotherapy with or without concurrent daily low-dose carboplatin in elderly patients with locally advanced non-small cell lung cancer: a phase iii trial of the japan clinical oncology group (jcog9812). Jpn J Clin Oncol 35:195–201

    Article  PubMed  Google Scholar 

  4. Davidoff AJ, Gardner JF, Seal B et al (2011) Population-based estimates of survival benefit associated with combined modality therapy in elderly patients with locally advanced non-small cell lung cancer. J Thorac Oncol 6:934–941

    Article  PubMed  Google Scholar 

  5. Okamoto I, Fukuoka M (2009) S-1: a new oral fluoropyrimidine in the treatment of patients with advanced non-small-cell lung cancer. Clin Lung Cancer 10:290–294

    Article  PubMed  CAS  Google Scholar 

  6. Kawahara M, Furuse K, Segawa Y et al (2001) Phase ii study of s-1, a novel oral fluorouracil, in advanced non-small-cell lung cancer. Br J Cancer 85:939–943

    Article  PubMed  CAS  Google Scholar 

  7. Zeng L, Ou G, Itasaka S et al (2008) Ts-1 enhances the effect of radiotherapy by suppressing radiation-induced hypoxia-inducible factor-1 activation and inducing endothelial cell apoptosis. Cancer Sci 99:2327–2335

    Article  PubMed  CAS  Google Scholar 

  8. Fukushima M, Sakamoto K, Sakata M et al (2010) Gimeracil, a component of s-1, may enhance the antitumor activity of x-ray irradiation in human cancer xenograft models in vivo. Oncol Rep 24:1307–1313

    PubMed  CAS  Google Scholar 

  9. Ichinose Y, Seto T, Sasaki T et al (2011) S-1 plus cisplatin with concurrent radiotherapy for locally advanced non-small cell lung cancer: A multi-institutional phase ii trial (west japan thoracic oncology group 3706). J Thorac Oncol 6:2069–2075

    Article  PubMed  Google Scholar 

  10. Ohyanagi F, Yamamoto N, Horiike A et al (2009) Phase ii trial of s-1 and cisplatin with concurrent radiotherapy for locally advanced non-small-cell lung cancer. Br J Cancer 101:225–231

    Article  PubMed  CAS  Google Scholar 

  11. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European organization for research and treatment of cancer, national cancer institute of the united states, national cancer institute of canada. J Natl Cancer Inst 92:205–216

    Article  PubMed  CAS  Google Scholar 

  12. Boku N, Yamamoto S, Fukuda H et al (2009) Fluorouracil versus combination of irinotecan plus cisplatin versus s-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol 10:1063–1069

    Article  PubMed  CAS  Google Scholar 

  13. Graham MV, Purdy JA, Emami B et al (1999) Clinical dose-volume histogram analysis for pneumonitis after 3d treatment for non-small cell lung cancer (nsclc). Int J Radiat Oncol Biol Phys 45:323–329

    Article  PubMed  CAS  Google Scholar 

  14. Rodrigues G, Lock M, D’Souza D et al (2004) Prediction of radiation pneumonitis by dose—volume histogram parameters in lung cancer—a systematic review. Radiother Oncol 71:127–138

    Article  PubMed  Google Scholar 

  15. Kong FM, Hayman JA, Griffith KA et al (2006) Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (nsclc): predictors for radiation pneumonitis and fibrosis. Int J Radiat Oncol Biol Phys 65:1075–1086

    Article  PubMed  Google Scholar 

  16. Schild SE, Stella PJ, Geyer SM et al (2003) The outcome of combined-modality therapy for stage iii non-small-cell lung cancer in the elderly. J Clin Oncol 21:3201–3206

    Article  PubMed  CAS  Google Scholar 

  17. Tsukuda M, Kida A, Fujii M et al (2005) Randomized scheduling feasibility study of s-1 for adjuvant chemotherapy in advanced head and neck cancer. Br J Cancer 93:884–889

    Article  PubMed  CAS  Google Scholar 

  18. Takigawa N, Kiura K, Hotta K et al (2011) A phase i study of s-1 with concurrent thoracic radiotherapy in elderly patients with localized advanced non-small cell lung cancer. Lung Cancer 71:60–64

    Article  PubMed  Google Scholar 

  19. Atagi S, Kawahara M, Yokoyama A et al (2011) Standard thoracic radiotherapy with or without concurrent daily low-dose carboplatin in elderly patients with locally advanced non-small cell lung cancer—a phase iii trial of the japan clinical oncology group (jcog0301). Eur J Cancer 47(The European Multidisciplinary Cancer Congress):273

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Correspondence to Isamu Okamoto.

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Hasegawa, Y., Okamoto, I., Takezawa, K. et al. A phase I study of S-1 with concurrent radiotherapy in elderly patients with locally advanced non-small cell lung cancer. Invest New Drugs 31, 599–604 (2013). https://doi.org/10.1007/s10637-012-9833-7

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  • DOI: https://doi.org/10.1007/s10637-012-9833-7

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