One paper about the Japan new medicine S1 in the treatment of st

The role of S-1 in the treatment of gastric cancer
Mariela A Blum
Akihiro Suzuki
Takashi Taketa
Jaffer Ajani
The University of Texas, MD
Anderson Cancer Center, Division
of Gastrointestinal Oncology,
Houston, TX, USA
Correspondence: Jaffer A Ajani
The University of Texas, MD Anderson
Cancer Center, 1515 Holcombe Blvd,
Mail Stop 426, Houston, TX 77030, USA
Tel [phone]
Fax [phone]
Email [e-mail]
Abstract: Gastric cancer is a lethal disease and continues to be the second leading cause of
cancer death worldwide. Surgical resection remains the main treatment for early stages with
complete resection having the potential for a cure. Recent data suggest that surgery alone is
inferior to surgery plus some form of adjunctive therapy. Unfortunately, most patients with gastric
cancer are diagnosed in advanced stages, rendering palliative systemic therapy as the only choice
of treatment. The most common chemotherapy combination as a first-line treatment in advanced
gastric cancer (AGC) includes a platinum compound, a fluoroporyrimidine and a taxane (in the
United States) or an antracycline (in Europe). Fluoropyrimidines have been the backbone in the
chemotherapy regimens for the treatment of gastric cancer. There has been considerable
interest
in oral fluoropyrimidines. S-1 is a fourth-generation oral fluoropyrimidine that combines tegafur,
which is a prodrug of 5-fluorouracil (5-FU), and two biochemical modulators: (1) 5-chloro-2,4-
dihydroxypyridine, a powerful but reversible inhibitor of dihydropyrimidine dehydrogenase that
prevents 5-FU degradation, and (2) potassium oxonate, which reduces gastrointestinal (GI) toxicity
by inhibition of 5-FU phosphorylation in the GI mucosa. S-1 has produced an advantage in
the postoperative setting in a large Phase III trial and has also been evaluated as a preoperative
chemotherapy in gastric cancer, but in the preoperative setting, there are no completed Phase III
clinical trials. Nonetheless, S-1 is considered, as a single agent, as the standard of care in Japan
for the adjuvant treatment of resected gastric cancer and in combination with cisplatin in the
advanced setting based on level 1 evidence in Phase III trials. S-1 is now widely available and
has been approved in 27 European countries as a first-line treatment for AGC. S-1 is generally
well tolerated with a low toxicity profile. It is a novel agent that provides a convenient and safe
advantage over intravenous fluoropyrimidine in AGC.
Keywords: tegafur, Ftorafur, FT, 5-FU, advanced gastric cancer
Introduction
Throughout

所有跟帖： 

• S1在中國和日本做的都是非劣性臨床研究（non-inferiority)，已經批準治胃癌和非小細胞肺癌（日本）。不一定比現有的化 -故鄉明月在- ♀ (0 bytes) () 02/23/2015 postreply 22:46:03