S-1 And Oxaliplatin Combination Chemotherapy for Patients with Refractory Pancreatic Cancer

ABSTRACT Purpose The aim of this study was to evaluate the efficacy and safety of S-1 and Oxaliplatin (Ox) combination chemotherapy for patients with refractory pancreatic cancer. Methods Between March 2009 and October 2011, 30 patients with pancreatic cancer refractory to previous chemotherapy were included. S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by a 7-day rest, and Ox was administered at 100 mg/m2 on day 1 every 3 weeks until disease progression or unacceptable toxicity was observed. Results The patients consisted of 22 men (73.3%) and 8 women with a median age of 64 years; 11 patients (36.7%) were in performance status (PS) of 0, 16 patients (53.3%) were in PS of 1, and 3 patients (10.0%) were in PS of 2. Seven patients (23.3%) had locally advanced disease, 19 patients (63.3%) had metastatic disease, and 4 patients (13.3%) had recurrent disease after surgical resection. A partial response was achieved in 3 (10.0%) and stable disease in 12 patients (40.0%), giving a disease control rate of 50.0% with a median of two courses (range from 1 to 8). The median time to progression (TTP) and overall survival (OS) were 3.4 (95% CI: 1.3–5.3) months and 5.2 (95% CI, 2.4–6.8) months, respectively. Eleven patients (36.7%) were previously treated with gemcitabine monotherapy and received this combination chemotherapy as a second-line treatment. Nineteen patients (63.3%) had previously undergone monotherapy or combination chemotherapy containing gemcitabine, S-1, and/or irinotecan and recieved this combination chemotherapy as a third- or fourth-line treatment. TTP was significantly longer in patients without history of S-1 use (5.6 versus 2.8 months; P = 0.005). The relative dose intensity of S-1 and Ox was 89.0 and 96.7% of the scheduled dose, respectively. Major grade 3/4 adverse events included neutropenia (10.0%), anemia (3.3%), and diarrhea (6.7%). Peripheral neuropathy (limited to grade1/2) was observed in 43.3% of patients. There were no treatment-related deaths. Conclusions Combination chemotherapy with S-1 and Ox was moderately effective and well-tolerated in patients with refractory pancreatic cancer.