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Fluorouracil has been widely used in the world as an anti-cancer drug for more than 40 years. S-1 is an oral, fixed dose combination, immediate release capsule containing tegafur (FT), a fluoropyrimidine prodrug of 5-fluorouracil (5-FU), and 2 modulators of 5-FU metabolism, gimeracil,(CDHP) and oteracil potassium (Oxo). S-1 has been designed to provide oral delivery of 5-FU, apyrimidine analog antimetabolite antineoplastic agent, while reducing the rate of degradation of 5-FUand its conversion in the gastrointestinal (GI) tract to its toxic phosphorylated metabolite. CDHP, whenco-administered with tegafur, inhibits the catabolism and subsequent inactivation of 5-FU by inhibiting the enzyme DPD (dihydropyrimidine dehydrogenase), so that exposure to 5-FU is increased. Oxo inhibits the anabolism of 5-FU to 5-fluorouridine-5’-monophosphate (FUMP) by inhibiting the enzyme OPRT (orotate phosphoribosyl transferase). Oxo has been shown to distribute into normal gastrointestinal (GI) tract tissues with minimal to no distribution into tumor cells. It is therefore part of the fixed dose combination in order to minimize 5-FU toxicity in GI tissues without compromising systemic antitumor effects. S-1 should only be prescribed by a qualified doctor experienced in treating cancer patients with anticancer medicines. Patients must be frequently monitored for changes in the laboratory data suggestive of bone marrow suppression, such as decreases in hemoglobin, white blood cells, neutrophils, and platelets.

For details, please refer to:Physicians’ World

• S-1 ® is an antineoplastic drug approved in gastric cancer.

•So far, the results of Phase III clinic trial indicate that postoperative adjuvant therapy with S-1 was confirmed to improve overall survival and relapse-free survival in patients with stage II or III gastric cancer who had undergone D2 gastrectomy.

• It is approved in Japan for the treatment of gastric cancer, head and neck cancer, colorectal cancer, non-small cell lung cancer, nonoperable or recurrent breast cancer, pancreatic cancer and biliary tract cancer. S-1 is approved inSouth Korea for the treatment of gastric cancer and head and neck cancer,and in Singapore for postoperative adjuvant chemotherapy for locally advanced

For details, please refer to: Care for Patients