A Randomized, Open, Multi-center, Phase III Study of S-1+Oxaliplatin vs.S-1+Cisplatin First-line Treatment in Advanced or Recurrent Diffuse Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma Patients
1. histologically confirmed unresectable advanced or recurrent diffuse-type gastric
adenocarcinoma or gastroesophageal junction adenocarcinoma.
2. 18 years old to 75 years old, able to conduct oral administration.
3. Measurable disease, according to the Response Evaluation Criteria in Solid
Tumours(RECIST 1.1)，except non-measurable but evaluable disease,such as peritoneal
4. No palliative chemotherapy and radiotherapy. Previous adjuvant or neoadjuvant
chemotherapy , if applicable, more than 12 months.
5. ECOG systemic status score of 0 to 2.
6. normal organ function, that meet the following criteria:
1. ALT and AST<2.5 times ULN (≤5 times ULN in patients with liver metastases)
2. ALP ≤ 2 times ULN ; (for patients with liver metastases can be no limit to the
3. Total bilirubin ≤ 1 times ULN.
4. Absolute neutrophil count ≥ 2.0 × 10 9 / L.
5. Platelet count ≥ 100 × 10 9 / L.
6. Hemoglobin ≥ 80g / L.
7. Creatinine ≤ 1.25 times ULN.
8. The estimated creatinine clearance ≥ 60 mL/min (Cockcroft-Gault formula).
7. signed informed consent, treatment, follow-up and inspection in accordance with the
8. life expectancy greater than 3 months.
9. at least 3 weeks after major surgery.
1. Previous adjuvant or neoadjuvant chemotherapy within the prescribed time
2. the investigator determines that the patient is not suitable for participation in
this study, and specifically includes (but is not limited to):
1. The past five years there have been other malignancies, but after appropriate
treatment of cervical carcinoma in situ and non-melanoma skin cancer.
2. brain metastases or leptomeningeal metastasis.
3. myocardial infarction (within the past six months), severe unstable angina,
congestive heart failure.
4. Serious complications (including paralytic ileus, intestinal obstruction,
interstitial pneumonia, lung fibrosis, beyond the control of diabetes, renal
insufficiency and cirrhosis of the liver, etc.).
5. Chronic nausea, vomiting, or diarrhea (per day greater than or equal to 4 times
or watery stools).
6. Gastrointestinal bleeding, and need for frequent blood transfusions.
7. human immunodeficiency virus (HIV) carrier or suffering from AIDS (AIDS).
8. Suffering from a mental illness.
9. neuropathy severity ≥grade 2 .
10. Infectious disease or inflammation, body temperature ≥ 38 ℃.
3. Cisplatin, oxaliplatin, or S-1 allergy.
4. Pregnancy or breast-feeding women.
5. refused to take appropriate contraceptive measures (including male patients).
6. Under experimental drug within 4 weeks.
7. Under other anti-cancer treatment.