Difference between revisions of "Tegafur, gimeracil, oteracil (S-1)"

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''Note: this drug is approved in Japan and has been extensively studied there. Full references will not be provided until if/when the drug is FDA approved.''
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''Note: this drug is approved in Japan and Europe but not the US.''
  
 
=Mechanism of action=
 
=Mechanism of action=
 
From the NCI Drug Dictionary: An orally bioavailable fluoropyrimidine antagonist composed of tegafur combined with two modulators of 5-flurouracil (5-FU) activity, 5-chloro-2,4-dihydroxypyridine (CDHP) and potassium oxonate, in a molar ratio of 1:0.4:1. Tegafur is a prodrug of 5-fluorouracil, an antimetabolite that inhibits thymidylate synthase, DNA synthesis and cell division, and competes with uridine triphosphate, thus inhibiting RNA and protein synthesis. CDHP is a reversible inhibitor of dihydropyrimidine dehydrogenase (DPD), the liver enzyme responsible for rapid catabolism of 5-FU into inactive metabolites. Potassium oxonate preferentially localizes in the gut and inhibits the enzyme orotate phosphoribosyl-transferase (OPRT), thereby decreasing activation of 5-FU in the gut and activated 5-FU-related gastrointestinal toxicity.
 
From the NCI Drug Dictionary: An orally bioavailable fluoropyrimidine antagonist composed of tegafur combined with two modulators of 5-flurouracil (5-FU) activity, 5-chloro-2,4-dihydroxypyridine (CDHP) and potassium oxonate, in a molar ratio of 1:0.4:1. Tegafur is a prodrug of 5-fluorouracil, an antimetabolite that inhibits thymidylate synthase, DNA synthesis and cell division, and competes with uridine triphosphate, thus inhibiting RNA and protein synthesis. CDHP is a reversible inhibitor of dihydropyrimidine dehydrogenase (DPD), the liver enzyme responsible for rapid catabolism of 5-FU into inactive metabolites. Potassium oxonate preferentially localizes in the gut and inhibits the enzyme orotate phosphoribosyl-transferase (OPRT), thereby decreasing activation of 5-FU in the gut and activated 5-FU-related gastrointestinal toxicity.
  
=Preliminary data=
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==Diseases for which it is established==
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*[[Breast cancer]]
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*[[Cholangiocarcinoma]]
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*[[Colorectal cancer]]
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**[[Colon cancer]]
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**[[Rectal cancer]]
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*[[Gallbladder cancer]]
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*[[Gastric cancer]]
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*[[Head and neck cancer]]
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*[[Non-small cell lung cancer]]
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**[[Non-small cell lung cancer, squamous]]
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*[[Pancreatic cancer]]
  
==[[Pancreatic cancer]]==
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==Diseases for which it is used==
# Uesaka K, Boku N, Fukutomi A, Okamura Y, Konishi M, Matsumoto I, Kaneoka Y, Shimizu Y, Nakamori S, Sakamoto H, Morinaga S, Kainuma O, Imai K, Sata N, Hishinuma S, Ojima H, Yamaguchi R, Hirano S, Sudo T, Ohashi Y; JASPAC 01 Study Group. Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet. 2016 Jul 16;388(10041):248-57. Epub 2016 Jun 2. [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30583-9/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27265347 PubMed]
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*[[Esophageal cancer]]
  
[[Category:Drug index]]
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==History of changes in EMA indication==
[[Category:Chemotherapy]]
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*2011-03-14: Initial marketing authorization as Teysuno.
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==History of changes in PMDA indication==
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*2005-11-14: New indication for the treatment of inoperable or recurrent [[breast cancer]].
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*2006-08-10: New indication for [[pancreatic cancer]].
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*2007-08-23: New indication for the treatment of [[:Category:Biliary tract cancers|biliary cancer]] in addition to [[gastric cancer]], [[colorectal cancer]], [[head and neck cancer]], [[non-small cell lung cancer]], and [[pancreatic cancer]].
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*2007-08-23: New indication for the treatment of inoperable or relapsed [[breast cancer]].
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*2022-11-24: New indication and a new dosage for the postoperative adjuvant treatment of hormone receptor(HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative [[breast cancer]] with a high risk of recurrence.
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==Also known as==
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*'''Code name:''' S-1
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*'''Brand name:''' Teysuno, TS-One, TS-1
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[[Category:Drugs]]
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[[Category:Combination drugs]]
 
[[Category:Oral medications]]
 
[[Category:Oral medications]]
  
 
[[Category:Fluoropyrimidines]]
 
[[Category:Fluoropyrimidines]]
  
[[Category:EMA approved drugs]]
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[[Category:Breast cancer medications]]
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[[Category:Cholangiocarcinoma medications]]
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[[Category:Colon cancer medications]]
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[[Category:Colorectal cancer medications]]
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[[Category:Esophageal cancer medications]]
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[[Category:Gallbladder cancer medications]]
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[[Category:Gastric cancer medications]]
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[[Category:Non-small cell lung cancer medications]]
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[[Category:Non-small cell lung cancer, squamous medications]]
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[[Category:Pancreatic cancer medications]]
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[[Category:Rectal cancer medications]]
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[[Category:EMA approved in 2011]]
 
[[Category:PMDA approved drugs]]
 
[[Category:PMDA approved drugs]]

Latest revision as of 00:26, 7 November 2023

Note: this drug is approved in Japan and Europe but not the US.

Mechanism of action

From the NCI Drug Dictionary: An orally bioavailable fluoropyrimidine antagonist composed of tegafur combined with two modulators of 5-flurouracil (5-FU) activity, 5-chloro-2,4-dihydroxypyridine (CDHP) and potassium oxonate, in a molar ratio of 1:0.4:1. Tegafur is a prodrug of 5-fluorouracil, an antimetabolite that inhibits thymidylate synthase, DNA synthesis and cell division, and competes with uridine triphosphate, thus inhibiting RNA and protein synthesis. CDHP is a reversible inhibitor of dihydropyrimidine dehydrogenase (DPD), the liver enzyme responsible for rapid catabolism of 5-FU into inactive metabolites. Potassium oxonate preferentially localizes in the gut and inhibits the enzyme orotate phosphoribosyl-transferase (OPRT), thereby decreasing activation of 5-FU in the gut and activated 5-FU-related gastrointestinal toxicity.

Diseases for which it is established

Diseases for which it is used

History of changes in EMA indication

  • 2011-03-14: Initial marketing authorization as Teysuno.

History of changes in PMDA indication

Also known as

  • Code name: S-1
  • Brand name: Teysuno, TS-One, TS-1