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Choice of Capecitabine or S1 in Combination with Oxaliplatin based on Thymidine Phosphorylase and Dihydropyrimidine Dehydrogenase Expression Status in Patients with Advanced Gastric Cancer
Journal of Gastric Cancer ; : 408-416, 2019.
Artigo em Inglês | WPRIM | ID: wpr-785961
ABSTRACT

PURPOSE:

To study the efficacy of capecitabine or S-1 plus oxaliplatin (CAPOX or SOX) for treating thymidine phosphorylase (TP)- or dihydropyrimidine dehydrogenase (DPD)-positive advanced gastric cancer.MATERIALS AND

METHODS:

Eighty-six patients with stage IIIC to IV gastric cancer were assessed for TP and DPD expression by immunohistochemistry. The association between CAPOX or SOX efficacy and TP/DPD expression was retrospectively analyzed.

RESULTS:

There were no significant differences in the objective remission rate (ORR, 52.27% vs. 47.62%; P>0.05), disease control rate (72.73% vs. 73.81%, P>0.05), progression-free survival (hazard ratio [HR], 1.119; 95% confidence interval [CI], 0.739–1.741; P=0.586), and overall survival (OS; HR, 0.855; 95% CI, 0.481–1.511; P=0.588) between CAPOX and SOX. A higher number of stage IV patients showed TP positivity, while DPD-positive patients predominantly showed intestinal type of gastric cancer. In TP-positive patients, the ORRs associated with CAPOX and SOX treatments were 57.14% and 38.10%, respectively; OS was better with CAPOX than with SOX (HR, 0.447; 95% CI, 0.179–0.978; P=0.046). Among DPD-positive patients, the SOX treatment-associated ORR (60.87%) was significantly higher than the CAPOX treatment-associated ORR (43.48%). Furthermore, SOX treatment resulted in better OS than did CAPOX treatment (HR, 2.020; 95% CI, 1.019–4.837; P=0.049).

CONCLUSIONS:

No significant difference in clinical efficacy was found between CAPOX and SOX. TP-positive patients might respond better to CAPOX while DPD-positive patients may respond better to SOX. Our findings might serve as a guide for personalized chemotherapy for gastric cancer.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Gástricas / Timidina / Timidina Fosforilase / Imuno-Histoquímica / Estudos Retrospectivos / Resultado do Tratamento / Intervalo Livre de Doença / Di-Hidrouracila Desidrogenase (NADP) / Tratamento Farmacológico / Capecitabina Tipo de estudo: Estudo observacional Limite: Humanos Idioma: Inglês Revista: Journal of Gastric Cancer Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Gástricas / Timidina / Timidina Fosforilase / Imuno-Histoquímica / Estudos Retrospectivos / Resultado do Tratamento / Intervalo Livre de Doença / Di-Hidrouracila Desidrogenase (NADP) / Tratamento Farmacológico / Capecitabina Tipo de estudo: Estudo observacional Limite: Humanos Idioma: Inglês Revista: Journal of Gastric Cancer Ano de publicação: 2019 Tipo de documento: Artigo