S-1 (Teysuno) and gemcitabine in Caucasian patients with unresectable pancreatic adenocarcinoma

Stine Braendegaard Winther, Jon Kroll Bjerregaard, Katrine Rahbek Schonnemann, Mathilde Weisz Ejlsmark, Merete Krogh, Helle Anita Jensen, Per Pfeiffer

Research output: Contribution to journalJournal articleResearchpeer-review


PURPOSE: Gemcitabine has been standard of care in advanced pancreatic adenocarcinomas (PC) for almost two decades. Randomized, primarily Japanese, studies have shown promising efficacy when combined with S-1 (GemS-1); however, no data are published in Caucasian patients. We report the first study with a combination of GemS-1 in an unselected cohort of Caucasian PC patients.

METHODS: In this observational cohort study, we analyzed efficacy and toxicity prospectively.

RESULTS: From July 2012 to July 2014, 64 patients received at least one cycle of GemS-1. 16 patients started therapy with gemcitabine and capecitabine (GemCap) but switched to GemS-1 after median 3 cycles of GemCap due to toxicity (hand-foot syndrome). 48 patients received GemS-1 as initial therapy. For the complete cohort, median age was 68 years (range 44-80); 22 patients (34%) had locally advanced PC; 42 patients (66%) had metastatic disease. Five patients had received prior adjuvant therapy with gemcitabine and 9 pts had received prior first-line therapy. The most common adverse event was fatigue (86%), however, only grade 3 in 3%. Five patients (8%) developed febrile neutropenia. Median PFS was 8.1 (95% CI 6.9-9.0) months and median OS was 11.7 (95% CI 10.7-13.1) months in the whole GemS-1 population. In the 48 patients starting with GemS-1, median PFS was 7.7 (95% CI 6.7-8.9) months and median OS was 11.5 (95% CI 9.7-12.3) months.

CONCLUSIONS: The combination of gemcitabine and S-1 is safe and associated with promising efficacy in a Caucasian population; however, this needs to be confirmed in prospective clinical trials.

Original languageEnglish
JournalCancer Chemotherapy and Pharmacology
Issue number3
Pages (from-to)573–578
Publication statusPublished - Mar 2018


  • Journal Article
  • Gemcitabine
  • Pancreatic cancer
  • S-1
  • Caucasian population
  • Humans
  • Middle Aged
  • Male
  • Antineoplastic Combined Chemotherapy Protocols/adverse effects
  • Neutropenia/chemically induced
  • Aged, 80 and over
  • Adult
  • Female
  • Adenocarcinoma/drug therapy
  • Pancreatic Neoplasms/drug therapy
  • Diarrhea/chemically induced
  • Kaplan-Meier Estimate
  • European Continental Ancestry Group
  • Treatment Outcome
  • Deoxycytidine/administration & dosage
  • Tegafur/administration & dosage
  • Fatigue/chemically induced
  • Oxonic Acid/administration & dosage
  • Aged
  • Drug Combinations
  • Cohort Studies


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