Onkologie. 2013:7(5):242-244

Chemoterapy of advanced gastric cancer - do we need a new drug?

Tomáš Šálek

Onkologická klinika NOÚ, Bratislava

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. 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 and fluoropyrimidine.

Fluoropyrimidines have been the backbone in the chemotherapy regimens for the treatment of gastric cancer. Teysuno® (S-1) is

a peroral fourth-generation fluoropyrimidine that combines tegafur, which is a prodrug of 5-fluorouracil (5-FU), and two biochemical

modulators: 5-chloro-2,4-dihydroxypyridine, a powerful but reversible inhibitor of dihydropyrimidine dehydrogenase that prevents 5-FU

degradation, and potassium oxonate, which reduces gastrointestinal (GI) toxicity by inhibition of 5-FU phosphorylation in the GI mucosa.

Teysuno® (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 European countries with trade name Teysuno® 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 peroral advantage over intravenous fluoropyrimidine in AGC.

Keywords: gastric cancer, S-1, fluoropyrimidines, cisplatin

Published: November 1, 2013  Show citation