GEST

NCT00498225 📎

Regimen

Experimental
Arm 1: gemcitabine + S-1 (GS). Arm 2: S-1 monotherapy 40-60 mg BID d1-28 q6w. Arm 3: gemcitabine 1000 mg/m2 weekly (reference).
Control
Three-way comparison (non-inferiority design for S-1 vs gemcitabine; superiority for GS vs gemcitabine).

Population

Chemo-naive locally advanced or metastatic PDAC, ECOG 0-1, Japanese + Taiwanese multicenter (enrolled 2007-2009).

Key finding

GEST confirmed oral S-1 is non-inferior to gemcitabine in East Asian advanced PDAC, with better convenience (all-oral) and tolerability. GS combination failed to show superiority over gem monotherapy for OS, though numerically better in locally advanced subgroup (median OS 15.9 vs 12.7 mo).

Source: PMID 23547081

Timeline

    Guideline citations

    • NCCN PANCREATIC (p.8)