***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE S-1 or capecitabine plus oxaliplatin are considered active and tolerable in gastric cancer patients . We conducted a r and omized phase II trial in gastric cancer patients to compare the activity and safety of these combinations . METHODS The patients received S-1 at 80 mg/m2 for 14 days , followed by a 7-day rest period within a 3-week schedule in the S-1/oxaliplatin ( SOX ) arm , and capecitabine at 2000 mg/m2 for 14 days , followed by a 7-day rest period within a 3-week schedule in the capecitabine/oxaliplatin ( CAPOX ) arm . Oxaliplatin 130 mg/m2 was administered every 3 weeks in both arms . RESULTS One hundred twenty-nine patients were r and omly assigned to SOX ( N=65 ) or CAPOX ( N=64 ) . The median time to progression and the overall survival were 6.2 and 12.4 months with SOX , respectively ; and 7.2 and 13.3 months with CAPOX , respectively . The overall response rates were 40 % and 44 % for SOX and CAPOX , respectively . The most frequent grade 3 or 4 toxicities were thrombocytopenia ( 15.4 % ) for SOX and neutropenia ( 18.8 % ) for CAPOX . The median time to 10 % deteriorations in global health scores was similar in both arms ( SOX , 4.3 months , CAPOX , 4.9 months ) . CONCLUSION Both the SOX and CAPOX regimens were equally active and well tolerated in advanced gastric cancer patients Objectives : To evaluate the efficacy and safety of capecitabine in patients with advanced or recurrent gastric cancer , we conducted a pilot phase II study in Japan . Methods : Patients with advanced or recurrent gastric cancer were given oral capecitabine 828 mg/m2 twice daily for 3 weeks , followed by 1 week of no treatment . Two or more cycles were administered . From July 1996 to December 1997 , 32 patients were enrolled in the study . The response to capecitabine was evaluated in 31 patients , excluding 1 found to be ineligible . Results : The overall response rate was 19.4 % ( 6/31 , 95 % confidence interval : 7.5–37.5 % ) . The median duration of response was 124.5 days , the median time to disease progression 85.0 days , and the median survival time 247.5 days . Drug-related adverse events of grade 3 or higher were infrequent : in 2 patients ( 6.3 % ) total bilirubin concentration increased , and 1 patient ( 3.1 % ) each had elevation of GOT , anemia , lymphopenia , increased creatinine , and h and -foot syndrome . No patient had gastrointestinal toxicity of grade 3 or higher . Conclusion : Capecitabine was suggested to be safe and effective in the treatment of advanced or recurrent gastric cancer . Further phase II studies of capecitabine on a large scale are warranted A phase III r and omised study , comparing treatment with fluorouracil , epidoxorubicin and methotrexate ( FEMTX ) with the best supportive care , was conducted in patients with unresectable or metastatic gastric cancer . During the period from July 1986 to June 1992 , 41 patients were r and omised to receive FEMTX or best supportive care . MTX was given in a dose of 1500 mg m-2 intravenously ( i.v . ) followed after 1 h by 5-FU 1500 mg m-2 i.v . on day 1 ; leucovorin rescue was started after 24 h ( 30 mg orally every 6 h for 48 h ) and epidoxorubicin 60 mg m-2 i.v . was administered on day 15 . In addition both groups received tablets containing vitamins A and E. Response rates for FEMTX were as follows : complete response ( CR ) , 19 % ( 4/21 ) ; partial response ( PR ) , 10 % ( 2/21 ) ; no change ( NC ) , 33 % ( 7/21 ) ; and progressive disease ( PD ) , 24 % ( 5/21 ) . Response rates in the control group were : NC , 20 % ( 4/20 ) ; and PD , 80 % ( 16/20 ) . Increased pain was observed in one patient in the treated group and in 11 patients in the control group within the first 2 months . WHO grade III/IV toxicity in the chemotherapy group was as follows : nausea/vomiting 40 % , diarrhoea 10 % , stomatitis 15 % , leucopenia 50 % and thrombocytopenia 10 % . One possible treatment-related death was due to sepsis . The median time to progression in the FEMTX group was 5.4 months [ 95 % confidence interval ( CI ) 3.1 - 11.7 months ] , but only 1.7 months in the control group ( 95 % CI 1.2 - 2.7 months ) ( P = 0.0013 ) . Similarly , the FEMTX group displayed significantly ( P = 0.0006 ) prolonged survival compared with the control group , i.e. median survival 12.3 months ( 95 % CI 7.1 - 15.6 months ) vs 3.1 months ( 95 % CI 1.6 - 4.6 months ) . In conclusion , FEMTX combined with vitamin A and E is a fairly well-tolerated treatment , giving a response rate of 29 % in patients with advanced gastric cancer , and also prolonging patients ' survival . It can be used as a reference treatment in testing new investigational combinations BACKGROUND This study aim ed to evaluate the safety and efficacy of oral fluoropyrimidines and cisplatin therapy in elderly patients with untreated advanced gastric cancer ( AGC ) retrospectively . In addition , we evaluated the relative activity and toxicity of these agents in this patient population . METHODS Clinical data from 72 patients with previously untreated AGC , who were treated with capecitabine/cisplatin and S-1/cisplatin , were review ed .  Oral fluoropyrimidines were administered orally twice a day on Days 1 - 14 . The dose of capecitabine was 1250 mg/m(2 ) and that of S-1 was 50 mg [ body surface area ( BSA ) < 1.5 m(3 ) ] or 60 mg ( BSA > 1.5 m(3 ) ) twice a day . Cisplatin was administered intravenously on Day 1 ( before the first dose of capecitabine or S-1 ) at a dose of 70 mg/m(2 ) over a 2 h period . The chemotherapy cycle was of 3 weeks ( with oral capecitabine or S-1 ) . RESULTS Thirty-two and 40 patients received the S-1  and capecitabine  regimens , respectively , and were included in the analysis . The S-1 protocol had a response rate of 40.6 % , a median time-to-progression ( TTP ) of 5.4 months and a median survival of 9.6 months . The capecitabine had a response rate of 55 % , a median TTP of 5.9 months and a median survival of 10.2 months . Each protocol had a similar incidence of Grade 3 or 4 adverse events . However , there was a higher rate of the h and -foot syndrome ( 6 versus 37 % ) and diarrhea ( 25 versus 32 % ) in the capecitabine group . CONCLUSION Oral fluoropyrimidines and cisplatin in elderly patients with untreated AGC showed encouraging results . The treatment was well tolerated with a manageable toxicity profile . The comparison of S-1 with capecitabine showed that capecitabine had a slightly higher response rate ( statistically not significant ) in addition to a higher rate of adverse events such as the h and -foot syndrome and diarrhea . These data should be warranted with further prospect i ve studies Background . In an attempt to decrease the toxic effects of fluorouracil , doxorubicin , and methotrexate ( FAMTX ) by reducing the dose of methotrexate from 1500 mg/m2 , according to the original regimen , to 1000 mg/m2 , the authors design ed the modified FAMTX treatment that was evaluated in a prospect i ve Phase II‐III r and omized trial Purpose S-1 is a fourth-generation oral fluoropyrimidine that was developed to mimic the effects achieved with protracted continuous infusion of 5-fluorouracil ( 5-FU ) . This phase II study evaluated the efficacy and safety of S-1 salvage chemotherapy in patients with paclitaxel- and cisplatin-refractory gastric cancer . The primary end point was progression-free survival ; secondary end points were overall survival , safety , and clinical benefit . Methods Patients were eligible for the study if they had histologically documented gastric adenocarcinoma previously treated with paclitaxel and cisplatin , age ≥ 18 years , Eastern Clinical Oncology Group performance status ≤2 , adequate organ function , and no evidence of gastrointestinal obstruction or passage disturbance . Patients were treated with a dose of S-1 based on body surface area ( BSA ) as follows : BSA < 1.25 m2 , 80 mg/day ; 1.25 ≤ BSA < 1.5 m2 , 100 mg/day ; BSA ≥ 1.5 m2 , 120 mg/day . The total dose was divided in two and administered twice daily for 4 weeks followed by a 2-week rest period . Results Of the 53 patients enrolled in this study , 49 were evaluable . A total of 190 chemotherapy cycles were administered , and the median number of cycles was 2 . Five patients ( 9.4 % ) had a partial response , and 18 ( 34 % ) had stable disease . Median progression-free survival and overall survival were 4.9 and 10.4 months , respectively . Grade 3/4 hematological toxicities included neutropenia in six patients ( 11 % ) but no cases of febrile neutropenia were found . Most of the non-hematological toxicities were diarrhea , asthenia , and mucositis , but none reached grade 3 or grade 4 in severity . Improvement of pain was observed in 17 patients ( 32.1 % ) . Conclusions S-1 monotherapy provides active and safe salvage chemotherapy for patients with advanced gastric cancer who have been previously treated with paclitaxel and cisplatin PURPOSE To investigate the side effects , determine the maximum-tolerated dose ( MTD ) , and study the pharmacokinetics of S-1 , an oral fluoropyrimidine-based antineoplastic agent consisting of the fluorouracil ( 5-FU ) prodrug tegafur combined with two modulators , 5-chloro-2,4-dihydroxypyridine and potassium oxonate . PATIENTS AND METHODS Patients with advanced solid tumors received S-1 bid for 28 days , followed by 1 week of rest .  5-FU pharmacokinetics were investigated after a single initial dose of S-1 during the first 24 hours and weekly thereafter . RESULTS Twenty-eight patients received S-1  at the four consecutive dose levels of 25 , 45 , 35 , and 40 mg/m(2 ) . The MTD was initially found at 45 mg/m(2 ) , with diarrhea as the dose-limiting toxicity ( DLT ) . Diarrhea was also the DLT at the dose of 40 mg/m(2 ) , which was the MTD for patients exposed to extensive prior chemotherapy . Other toxicities were generally mild . Two patients had a reduction of more than 50 % in tumor dimension . Plasma pharmacokinetics of 5-FU were linear ; at the highest S-1 dose level , 5-FU plasma peak concentrations reached 1 to 2 micromol/L , and the half-life of 5-FU was 3 to 4 hours . A statistically significant relationship was observed between the severity of diarrhea and pharmacokinetic parameters of 5-FU . CONCLUSION The recommended dose of S-1 in chemotherapy-naive or minimally chemotherapy-exposed patients is 40 mg/m(2 ) bid on 28 consecutive days , every 5 weeks . In heavily pretreated patients , the recommended dose is 35 mg/m(2 ) bid . Phase II trials are warranted in tumors known to be responsive to 5-FU treatment OBJECTIVE To observe the efficacy and safety of chemotherapy regimens oxaliplatin combined with capecitabine ( CAPOX ) or oxaliplatin combined with tegafur , gimeracil and oteracil potassium capsules (S-1)(SOX ) , and to investigate the value of expression of thymidine phosphorylase ( TP ) and dihydropyrimidine dehydrogenase ( DPD ) proteins in tumor tissue for predicting the efficacy of CAPOX and SOX regimens in advanced gastric cancer patients . METHODS A total of 107 newly-diagnosed , stage Ⅲc/Ⅳ gastric 
    Output:
    
Conclusion This systematic review showed that for Asian patients  , Cap shows superiority in ORR but not 1-year OS or PFS , and it will increase the risk of all- grade HFS and neutropenia .
Until now , S-1 containing treatment might be a better choice for advanced gastric cancer patients .