Long-Term Administration of Second-Line Chemotherapy with S-1 and Gemcitabine for Platinum-Resistant Non-small Cell Lung Cancer: A Phase II Study

Standard second-line chemotherapies for non-small cell lung cancer (NSCLC) have been established but have limited clinical relevance. S-1 is a recently developed agent with potential activity against NSCLC. Patients with confirmed NSCLC recurrence after previous single- or two-regimen chemotherapy with platinum, performance status of 0 to 1, adequate organ functions, and measurable lesions were treated with S-1 (60 mg/m2/d, twice a day) on days 1 to 14 and gemcitabine (1000 mg/m2) on days 8 and 15, which were repeated every 3 weeks until tumor progression. Treatment was administered for a median of 4 courses (range, 1–13) over a median of 125-day period in 34 patients. The overall response rate was 23.5% (no complete response and eight partial response; 95% confidence interval: 9.1–38.0%). The median progression-free and overall survival times were 6.6 and 19.9 months, respectively. The 1- and 2-year survival rates were 58.8 and 30.9%, respectively. Toxicity was mild during the entire treatment period, except for three grade 3 interstitial pneumonia. The primary end point was met with the relatively high overall response rate. Randomized phase III studies for elucidating survival outcome of the regimen are warranted.