Efficacy and outcome analysis: monotherapy and combination therapy of S-1 for patients with advanced non-small cell lung cancer

Feiyi Cao; Wenjing Wang; Cuiping Gu; Yao Zhou; Ying Jin; Wei Hong

doi:10.21037/jtd-24-940

Efficacy and outcome analysis: monotherapy and combination therapy of S-1 for patients with advanced non-small cell lung cancer

J Thorac Dis. 2024 Oct 31;16(10):6483-6495. doi: 10.21037/jtd-24-940. Epub 2024 Oct 30.

Authors

Feiyi Cao^{1

2}, Wenjing Wang^{1

2}, Cuiping Gu¹, Yao Zhou¹, Ying Jin¹, Wei Hong¹

Affiliations

¹ Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
² Department of Medical Oncology, Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China.

Abstract

Background: Lung cancer is the leading cause of cancer-related mortality worldwide. S-1, a fluorouracil derivative known for its efficacy and minimal adverse effects in various solid tumors, offers hope for advanced non-small cell lung cancer (NSCLC) patients. This study conducted a retrospective, single-center analysis to investigate the effectiveness and safety of S-1 monotherapy and combination therapy as second-line or subsequent treatment for advanced NSCLC.

Methods: A total of 52 patients diagnosed with advanced NSCLC at Zhejiang Cancer Hospital (Hangzhou, China) from January 1, 2018, to August 31, 2023 were included in a retrospective study. Among these patients, 13 received S-1 monotherapy while 39 received S-1 in combination therapy. The study aimed to analyze the short-term efficacy, long-term outcome, prognostic factors, and treatment-related adverse events (AEs).

Results: The objective response rate (ORR) was 28.8%, with a median progression-free survival (PFS) of 2.7 months [95% confidence interval (CI): 2.1-2.8] and a median overall survival (OS) of 9.5 months (95% CI: 6.3-12.6) for the entire cohort. The combination therapy with S-1 was determined to be a significant independent predictor of OS, while treatment line was identified as an independent negative prognostic factor for OS. The most prevalent AE observed was anemia, affecting 12 patients (23.1%). The majority of AEs were classified as grade 1-2, with only 3 patients (5.7%) experiencing grade 3-4 AEs. Further prospective studies are recommended to fully assess the therapeutic value of this treatment approach.

Conclusions: Results indicated that both S-1 monotherapy and combination therapy showed promising efficacy and were well tolerated as second-line or later-line treatments for patients with advanced NSCLC. Further prospective studies are recommended to fully assess the therapeutic value of this treatment approach.

Keywords: Immune checkpoint inhibitors (ICIs); S-1; non-small cell lung cancer (NSCLC); second-line treatment.