714P - Fixed dose rate gemcitabine and S-1 combination therapy (FGS) as salvage chemotherapy for gemcitabine-refractory advanced pancreatic cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Pancreatic Cancer
Biological Therapy
Presenter Akiyoshi Kasuga
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors A. Kasuga1, N. Okano1, D. Naruge1, H. Kitamura1, A. Takasu1, F. Nagashima1, J. Furuse2
  • 1Division Of Medical Oncology, Kyorin university hospital, 1818611 - Tokyo/JP
  • 2Department Of Medical Oncology, Kyorin University School of Medicine, 181-8611 - Tokyo/JP



No standard salvage chemotherapy regimens has been established for patients with advanced pancreatic cancer after failure of gemcitabine-based treatment. Although a phase I/II clinical trial of FGS was conducted, the number of patients enrolled was small and the efficacy and safety of FGS is still not well known.


We retrospectively reviewed 67 patients who received FGS as salvage chemotherapy at our institution from March 2009 to Mach 2014. The selection criteria in this study was progressive disease under gemcitabine-based chemotherapy, ECOG performance status 2 as a 120-min infusion on day 1 and S-1 was administered orally twice a day at a dose of 40 mg/m2 on day 1 to 7. Cycles were repeated every 14 days.


Sixty-six patients were selected for the analysis. Twenty-two patients of them had received FGS as third line treatment. The overall responce rate was 12% and the disease control rate was 45%. The median progression-free survival time was 2.7 months and the median overall survival time was 6.0 months. The common grade 3/4 toxicities were leukopenia (11%), neutropenia (15%), diarrhea (3%), anorexia (2%) and fatigue (2%). Univariate analysis showed that performance status of >0, presence of ascites, serum carcinoembryonic antigen level of > 10 ng/ml, serum albumin level of 500 IU/L and serum C-reactive protein level of > 1.0 mg/dl were significantly associated with a poor prognosis. Multivariate analysis identified serum C-reactive protein level of > 1.0 mg/dl and serum albumin level of


FGS as salvage chemotherapy for patients with gemcitabine-refractory advanced pancreatic cancer is marginally effective and well tolerated in a practical setting. These results suggest FGS is of value to be further investigated in a clinical trial in patients with gemcitabine-refractory pancreatic cancer.


All authors have declared no conflicts of interest.