Journal Club : SALTO ; Randomised phase III trial of S-1 versus capecitabine in the first-line treatment of metastatic colorectal cancer: SALTO study by the Dutch Colorectal Cancer Group.
Journal Club : SALTO ; Randomised phase III trial of S-1 versus capecitabine in the first-line treatment of metastatic colorectal cancer: SALTO study by the Dutch Colorectal Cancer Group.
今週のプレゼンターは、薬学部5年生！
2017年4月、Ann Oncol に報告された、オランダ27施設による大腸がんに対するS-1とカペシタビンによる手足症候群（HFS）の差を確認した第３相RCT。
SALTO trial
P :
Patients with previously untreated mCRC and planned treatment with fluoropyrimidine monochemotherapy
E :
capecitabine (1250 mg/m 2 orally for patients <70 years; 1000 mg/m 2 for patients ≥70 years, twice-daily on days 1-14) in 3-weekly cycles, with bevacizumab optional
C :
S-1 (30 mg/m 2 orally twice-daily on days 1-14) in 3-weekly cycles, with bevacizumab optional
O :
The incidence of any grade HFS as assessed by physicians was 73% in the capecitabine group ( n =80) and 45% in the S-1 group ( n =80) (odds ratio [95% confidence interval] 0.31 [0.16-0.60], p =0.0005).
T : RCT, Phases3
S-1 contains the DPD- inhibitor gimeracil and indeed the concentration of the 5-FU catabolite α-fluoro-β-alanine (FBAL) was shown to be 18-fold lower after the administration of S-1 compared to capecitabine
感想・皆さんの意見
・S1はカペシタビンと比べHFSが少ない。一方、食欲低下が多い。
・単剤治療レジメンを臨床で選択することは少ないのでは？
・下痢は、S1が多い傾向。有意差はなし。
・治療初期からHFSの差があるように見える。