S-1+Low-Dose CDDP

A review of the published literature was undertaken to ascertain the trends in treatment schedules of combination of an oral fluorouracil derivative S-1 with low-dose CDDP (25 mg/m2 or less) for un-resectable and recurrent gastric cancer. The case reports demonstrated as follows: S-1 was given as standard doses of 80-120 mg/body. With regard to CDDP administration, 4 mg/m2 or less was given for 4-consecutive weeks following 2-weeks rest and 6-10 mg/m2 was given for 3-consecutive weeks following 2-weeks rest in the case of 5-day/week CDDP administration. There have been reports of 6-8 mg/m2 CDDP given once or twice a week and weekly CDDP of 10-25 mg/m2 without grade 3 or more adverse events. A phase I study demonstrated the recommend dose of CDDP in the case of 5-day/week was 4 mg/m2 in the regimen of 4-consecutive weeks and 2-weeks rest with a standard dose of S-1. Three phase I studies on weekly low-dose CDDP with S-1 showed the recommend doses were 20-25 mg/m2. S-1+low-dose and a high-dose (30-90 mg/m2) CDDP have come into wide use in Japan. There have been no differences between the case reports and the clinical studies in quantity and quality for both regimens. The unified regimen of S-1+low-dose CDDP as an outpatient based chemotherapy should be developed.