A Retrospective Study of Pegylated Liposomal Doxorubicin Combined with S-1 and Low-dose Oxaliplatin as First-Line Treatment for Advanced Gastric Cancer

Background: At present, the first-line treatment of advanced gastric cancer is oxaliplatin combined with fluorouracil (capecitabine or S-1). Is there a three-drug regimen in which the curative effect is higher than that of the two-drug regimen, but the side effects are not significantly increased? This retrospective study evaluated the efficacy and side effects of pegylated liposomal doxorubicin (PLD) combined with S-1 and low-dose oxaliplatin as first-line treatment for advanced gastric cancer. Methods: : Advanced gastric cancer patients who received PLD combined with S-1 and low-dose oxaliplatin (D-SOX) or standard SOX as first-line chemotherapy from Jan 2015 to Dec 2018 were included in the study. Overall survival (OS), progression-free survival (PFS), response rate (RR), and safety were assessed. Results: A total of 52 patients were included in this study. There were 23 cases in D-SOX group and 29 cases in SOX group. The median PFS was 7.1 months (95% CI 5.66–8.54 months) in the SOX group and 9.1 months (95% CI 4.2–14.0 months) in the D-SOX group (P=0.036). The median OS was 12.5 months (95% CI 7.31–17.70 months) in the SOX group and 19.5 months (95% CI 16.23–22.7 months) in the D-SOX group (P=0.017). The incidence of treatment-related grade III-IV adverse events was no more than 10%. The incidence of neurotoxicity was significantly reduced in the D-SOX group. Conclusions: : This study suggests that PLD combined with S-1 and low-dose oxaliplatin might be a safe and more effective treatment for advanced gastric cancer.