Phase II study of S-1, a novel oral fluorouracil, in advanced non-small-cell lung cancer

The purpose of this study was to evaluate the efficacy and safety of a nove l oral anticancer fluoropyrimidine derivative, S-1, in patients receiving i nitial chemotherapy for unresectable, advanced non-small-cell lung cancer ( NSCLC). Between June 1996 and July 1998, 62 patients with NSCLC who had not received previous chemotherapy for advanced disease were enrolled in this study. 59 patients (22 stage IIIB and 37 stage IV) were eligible for the ev aluation of efficacy and safety. S-1 was administered orally, twice daily, after meals. 3 dosages of S-1 were prescribed according to body surface are a (BSA) so that they would be approximately equivalent to 80 mg m(-2) day(- 1): BSA < 1.25 m(2), 40 mg b.i.d.; BSA : 1.25 but <1.5 m(2); 50 mg b.i.d., and BSA greater than or equal to 1.5 m(2): 60 mg b.i.d. One cycle consisted of consecutive administration of S-1 for 28 days followed by a 2-week rest period, and cycles were repeated up to 4 times. The partial response (PR) rate of the eligible patients was 22.0% (13/59); (95% confidence interval: 12.3-34.7%). A PR was observed in 22.7% (5/22) of the stage IIIB patients a nd 21.6% (8/37) of the stage IV patients. The median response duration was 3.4 months (1.1-13.7 months or longer). Grade 4 neutropenia was observed in one of the 59 patients (11.7%). The grade 3 or 4 toxicities consisted of d ecreased haemoglobin level in 1.7% of patients (1/59), neutropenia in 6.8% (4/59), thrombocytopenia in 1.7% (1/59), anorexia in 10.2% (6/59), diarrhoe a in 8.5% (5/59), stomatitis in 1.7% (1/59), and malaise in 6.8% (4/59), an d their incidences were relatively low. There were no irreversible, severe or unexpected toxicities. The median survival time (MST) of all patients wa s 10.2 months (95% confidence interval: 7.7-14.5 months), and the one-year survival rate was 41.1%. The MST of the stage IIIB patients was 7.9 months, and that of the stage IV patients was 11.1 months. The one-year survival r ates of the stage IIIB and IV patients were 30.7% and 47.4%, respectively. S-1 was considered to be an active single agent against NSCLC. Further stud y of S-1 with other active agents is warranted. (C) 2001 Cancer Research Ca mpaign http://www.bjcancer.com.