Sex differences in the safety of S-1 plus oxaliplatin and S-1 plus cisplatin for patients with metastatic gastric cancer.

Abstract

Previous studies have shown sex-related differences in the incidence of adverse events following treatment with fluoropyrimidines, however the mechanism of this difference is unknown. We examined sex-related differences in the safety of S-1 plus oxaliplatin (SOX) and S-1 plus cisplatin (CS) in 663 metastatic gastric cancer patients taking part in a phase III study. The incidences of leukopenia (odds ratio [OR] 1.9; P = .015), neutropenia (OR 2.2; P = .002), nausea (OR 2.0; P = .009), and vomiting (OR 2.8; P < .001) were increased in women versus men treated with SOX, while vomiting (OR 2.9; P < .001) and stomatitis (OR 1.8; P = .043) were increased in women versus men treated with CS. In contrast, male patients treated with CS experienced thrombocytopenia more often (OR 0.51; P = .009). The mean relative dose intensity of S-1 in SOX was 75.4% in women and 81.4% in men (P = .032). No difference in efficacy was observed between women and men undergoing either regimen. Sex-related differences in adverse reactions during SOX and CS treatment were confirmed in this phase III study. Further translational research studies are warranted to pursue the cause of this difference.

• Authors: Yasuhide Yamada, Wasaburo Koizumi, Kazuhiro Nishikawa, Masahiro Gotoh, Nozomu Fuse, Naotoshi Sugimoto, Tomohiro Nishina, Kenji Amagai, Keisho Chin, Yasumasa Niwa, Akihito Tsuji, Hiroshi Imamura, Masahiro Tsuda, Hirofumi Yasui, Hirofumi Fujii, Kensei Yamaguchi, Hisateru Yasui, Shuichi Hironaka, Ken Shimada, Ichinosuke Hyodo
• Journal: Cancer science (Cancer Sci) Vol. 110 Issue 9 Pg. 2875-2883 (Sep 2019) ISSN: 1349-7006 [Electronic] England
• PMID: 31254422 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)
• Copyright: © 2019 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Chemical References

• Drug Combinations
• Oxaliplatin
• S 1 (combination)
• Tegafur
• Oxonic Acid
• Cisplatin

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Cisplatin (administration & dosage, adverse effects)
• Disease-Free Survival
• Dose-Response Relationship, Drug
• Drug Combinations
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Nausea (chemically induced, epidemiology)
• Neutropenia (chemically induced, epidemiology)
• Oxaliplatin (administration & dosage, adverse effects)
• Oxonic Acid (administration & dosage, adverse effects)
• Sex Factors
• Stomach Neoplasms (blood, drug therapy, pathology)
• Stomatitis (chemically induced, epidemiology)
• Tegafur (administration & dosage, adverse effects)
• Thrombocytopenia (chemically induced, epidemiology)
• Vomiting (chemically induced, epidemiology)