IP/IV Paclitaxel plus S-1 regimen
OS extended by 5.5 months
Adding intraperitoneal paclitaxel to intravenous paclitaxel plus S-1 significantly prolongs overall survival in gastric cancer patients with peritoneal metastasis.
Yan, Chao · Yang, Zhongyin · Shi, Zheng · Lu, Sheng · Shi, Min · Nie, Mingming · Chen, Jian · Wu, Dan · Mou, Yiping · Xu, Yunyun · Wang, Yanong · Liu, Xiaowen · Cao, Hui · Gu, Jiayi · Yu, Jiren · Liu, Kai · Liu, Xinchun · Zhang, Jun · Yin, Kai · Zhu, Zhenggang
JAMA Oncology 2026
Specifications
- Median overall survival (IP group)
- {'zh': '19.4', 'en': '19.4'} months
- Median overall survival (PS group)
- {'zh': '13.9', 'en': '13.9'} months
- Overall survival hazard ratio
- {'zh': '0.67', 'en': '0.67'}
- Median progression-free survival (IP group)
- {'zh': '11.2', 'en': '11.2'} months
- Median progression-free survival (PS group)
- {'zh': '7.2', 'en': '7.2'} months
- Progression-free survival hazard ratio
- {'zh': '0.72', 'en': '0.72'}
- Grade 3-4 adverse event rate (IP group)
- {'zh': '38.5', 'en': '38.5'} %
- Grade 3-4 adverse event rate (PS group)
- {'zh': '41.9', 'en': '41.9'} %
Advantages
Significantly prolongs survival
Median overall survival was extended from 13.9 to 19.4 months, with a hazard ratio of 0.67, and progression-free survival also improved significantly.
No increased severe toxicity
Grade 3 or 4 adverse events occurred in 38.5% of the IP group versus 41.9% in the PS group, and no treatment-related deaths occurred, indicating an acceptable safety profile.
Clinically applicable
The regimen uses approved drugs with a defined intraperitoneal delivery protocol, validated in 9 hospitals, supporting adoption as first-line therapy.
Applications
- First-line gastric cancer:Provides a phase 3-validated first-line option for gastric cancer with peritoneal metastasis, replacing standard intravenous regimens.
- Chemotherapy for peritoneal metastasis:Delivers high intraperitoneal paclitaxel concentrations to target peritoneal metastases, enhancing local control.
- Intraperitoneal drug delivery:Uses intraperitoneal route to increase peritoneal drug exposure while maintaining systemic therapy.
- GI cancer combination therapy:Combines paclitaxel and S-1 for synergistic treatment in GI cancers.