Japanese Journal of Clinical Oncology Advance Access published online on August 2, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym057
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© 2007 Foundation for Promotion of Cancer Research
Relationship between Expression of Vascular Endothelial Growth Factor in Tumor Tissue from Gastric Cancers and Chemotherapy Effects: Comparison between S-1 alone and the Combination of S-1 plus CDDP
1 Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto, Shizuoka
2 Department of Gastrointestinal Oncology/Gastroenterology, National Cancer Center Hospital East, Tokyo
3 Department of Medical Oncology, Saitama Medical School, Saitama
4 Department of Gastrointestinal Oncology/Gastroenterology, National Cancer Center Hospital
5 Department of Gastroenterology, School of Medicine, East Hospital, Kitasato University, Tokyo, Japan
For reprints and all correspondence: Narikazu Boku, Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan. E-mail: n.boku{at}scchr.jp
Received January 16, 2007; accepted February 14, 2007
Background: We have reported that vascular endothelial growth factor (VEGF) expression in gastric cancers might be a selective marker between 5-fluorouracil (5-FU) and a combination of 5-FU plus cisplatin (CDDP). In this study, the relationship between VEGF expression and effects of S-1 with and without CDDP is investigated.
Methods: The subjects were 44 patients treated with S-1 (40 mg/m2, twice daily, days 1–28, repeated every 6 weeks) and 24 patients treated with S-1 plus CDDP (S-1 40 mg/m2, twice daily, days 1–21, CDDP, 60 or 70 mg/m2, day 8, repeated every 5 weeks). VEGF expression in pretreatment endoscopic biopsy samples was assessed immunohistochemically.
Results: Median survival times (MST) of the patients treated with S-1 and S-1 plus CDDP were 344 and 388 days. Among evaluable patients, the response rates of patients with VEGF (+) and (–) tumors to S-1 were 40% (6/15) and 54% (13/24), and to S-1 plus CDDP, 79% (15/19) and 80% (4/5). While the survival of patients with VEGF (–) tumors was slightly longer than those with VEGF (+) tumors in the S-1 group (MST, 425 versus 308 days, P = 0.42), patients with VEGF (+) tumors survived remarkably longer than those with VEGF (–) tumors in the S-1 plus CDDP group (MST, 570 versus 333 days, P = 0.19).
Conclusion: Similarly to our previous study, it is suggested that the effects of adding CDDP to S-1 might be more remarkable in gastric cancer patients with VEGF (+) tumors than in those with VEGF (–) tumors. These results should be confirmed in a large phase III study.
Key Words: vascular endothelial growth factor • S-1 • gastric cancer
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