682P - Retrospective study of S-1 based chemotherapy in elderly patients with advanced gastric cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Gastric Cancer
Geriatric Oncology
Biological Therapy
Presenter Ken Shimada
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors K. Shimada1, Y. Takinishi2, K. Kobayashi2, T. Sekikawa2, Y. Saitou2, H. Toshima1, A. Hisamatsu1, T. Nunoue2, Y. Kitahara2, K. Miyashita2, E. Kinugsa2
  • 1Internal Medicine, showa university kouto toyosu hospital, 135-8577 - Tokyo/JP
  • 2Internal Medicine, showa university northern yokohama hospital, 224-8503 - yokohama/JP



S-1 plus cisplatin (SP:SPIRITS trial) is the standard first-line chemotherapy for advanced and recurrent gastric cancer (AGC) in Japan. However, the Japanese Gastric cancer therapy guideline does not show the standard chemotherapy for elderly patients. The aim of study was to evaluate the efficacy and safety of SP comparing with other S-1 based regimen (SO) in elderly patients over seventy years of age.


All cases of AGC from 2002-2013 were treated with S-1 based chemotherapy at Showa University Northern Yokohama Hospital, classified into under sixty-nine years(Y) and over seventy years (E)of age. The clinical results were compared between Y treated with SP (YSP) and Y treated with SO (YSO), between E treated with SP (ESP) and E treated with SO (ESO), respectively.


A total of 211 cases of AGC were identified. One hundred twenty three patients were group Y, median age 58(range 19-63). Sixty four were YSP. Fifty nine were YSO. Eighty eight patients were group E, median age 76(range 70-86). Thirty eight were ESP. Fifty were ESO. The overall response rate (ORR) was 55.5% with YSP and 22.2%with YSO (P = 0.02). Median time to treatment failure (TTF) was 6.2 months for YSP and 4.2 months for YSO (P=0.03).Median overall survival (MST) was 14.2 months for YSP and 11.8 months for YSO (P = 0.008). ORR was 35% with ESP and 28% with ESO (no statistical significant). TTF was 3.8 months for ESP and 4.6 months for ESO (no significant). MST was 10.6 months for ESP and 12.2 months for ESO (no statistical significant). Frequent grade 3/4 toxicity for ESP vs ESO were: neutropenia(40% vs 12%), thrombocytopenia (11% vs 2%), fatigue (17% vs 2%),anorexia(20% vs 4%).


The results suggest that SP is not safe and useful for elderly patients with advanced gastric cancer.


All authors have declared no conflicts of interest.