Non-Platinum S-1 Chemotherapy Doublet in NSCLC

Investigators evaluated a non-platinum chemotherapy regimen of S-1 plus docetaxel or gemcitabine in patients with advanced non-small cell lung cancer (NSCLC) who had previously failed platinum-based doublet chemotherapy. The authors noted that S-1 plus cisplatin or carboplatin had achieved promising results in a previous trial.

According to the researchers, the S-1-based non-platinum doublet chemotherapy combination had promising safety and efficacy when used as a second-line treatment in a population of patients with advanced NSCLC. The study’s findings were presented in Frontiers in Oncology.

The study retrospectively enrolled 87 consecutive patients with advanced NSCLC from 8 cancer centers in East Asia who had received S-1 plus docetaxel or gemcitabine after failing platinum-based chemotherapy between January 2015 and May 2020.

The primary end point of the analysis was progression-free survival (PFS), and secondary end points were overall response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Researchers used a matching-adjusted indirect comparison method to compare their cohort with a historical docetaxel monotherapy cohort from a previous S-1 trial.

Non-Platinum Doublet With S-1 Chemotherapy in NSCLC

Investigators reported the participants had an ORR and DCR of 22.89% and 80.72%, respectively. Notably, the study population had a weighted median PFS of 7.90 and OS of 19.37 months, compared with a median PFS of 2.89 months and OS of 12.52 months in the docetaxel cohort.

Authors also found time to first subsequent treatment (TFST) after failing first-line chemotherapy was an independent predictive factor for PFS. Patients with a TFST >9 months had a median second-line PFS of 8.7 months, while patients with a TFST ≤9 had a median second-line PFS of 5.0 months (hazard ratio, 0.461; P=.049).

“In conclusion,” the authors summarized, “S-1-based non-platinum combination had promising efficacy and manageable toxicity in advanced NSCLC patients who had failed platinum doublet chemotherapy, indicating a favorable second-line option.”

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