Details

Autor(en) / Beteiligte

• Punt, Cornelis J.A.
• Kwakman, Johannes J.M.
• Mol, Linda
• Roodhart, Jeanine
• Hendriks, Mathijs
• Speetjens, Frank
• van Iersel, Liselot
• Trajkovic-Vidakovic, Marija
• Spierings, Leontine
• Helgason, Helgi
• Creemers, Geert-Jan
• de Groot, Jan Willem
• van Dodewaard-de Jong, Joyce
• Los, Maartje
• Koornstra, Rutger
• Baars, Arnold
• Koopman, Miriam
• Vink, Geraldine

Titel

Long-Term Safety Data on S-1 Administered After Previous Intolerance to Capecitabine-Containing Systemic Treatment for Metastatic Colorectal Cancer

Ist Teil von

• Clinical colorectal cancer, 2022-09, Vol.21 (3), p.229-235

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •All patients with capecitabine-induced hand-foot syndrome experienced a lower grade or complete resolution of symptoms after switch to S-1.•All patients with capecitabine-induced coronary artery vasospasm did not experience recurrent chest pain after switch to S-1.•S-1 is well tolerated in patients with capecitabine-induced toxicities.•A switch from capecitabine to S-1 does not appear to compromise efficacy of treatment. The oral fluoropyrimidine S-1 has shown comparable efficacy to capecitabine in Asian and some Western studies on metastatic colorectal cancer. S-1 is associated with a lower incidence of hand-foot syndrome (HFS) and cardiac toxicity. We assessed the long-term tolerability of S-1 in patients who discontinued capecitabine for reasons of HFS or cardiac toxicity. Patients with metastatic colorectal cancer who switched from capecitabine to S-1, given as monotherapy or in combination with other agents, were identified in a Dutch prospective cohort study (2016-2021). The incidence and severity of HFS, cardiotoxicity and other toxicities were assessed. Forty-seven patients were identified. The median duration of capecitabine treatment was 81 days (range 4-454). In 19 patients (40%) a dose reduction was applied prior to switch to S-1. Reasons for discontinuation of capecitabine were HFS in 36 (77%) patients, coronary artery vasospasms in 10 (21%) patients, and gastrointestinal toxicities in 1 patient (2%). The median number of S-1 cycles was 6 (range 1-36). The median time between last dose of capecitabine and first dose of S-1 was 11 days (range 1-49). After switch to S-1, all patients with prior HFS developed a lower grade or complete resolution of symptoms, and in all other patients symptoms did not recur. Other S-1-related adverse events were limited to grade 1-2. Six patients (13%) discontinued S-1 due to either known fluoropyrimidine-related or bevacizumab-related toxicities. Switch to S-1 did not appear to compromise treatment efficacy. S-1 is a valid alternative to capecitabine in case HFS or cardiotoxicity occurs. The oral fluoropyrimidine S-1 has mainly been tested in Asian patients and was shown to be a valid alternative to capecitabine in the treatment of metastatic colorectal cancer. We evaluated the outcome in 47 Western patients who switched from capecitabine to S-1 due to hand-foot syndrome or cardiac toxicity, derived from a prospective cohort study. S-1 was well tolerated in all patients, indicating that S-1 is of special interest for this patient population.