Tegafur/gimeracil/oteracil
Combination of | |
---|---|
Tegafur | Antineoplastic drug |
Gimeracil | Enzyme inhibitor |
Oteracil | Enzyme inhibitor |
Clinical data | |
Trade names | Teysuno |
AHFS/Drugs.com | UK Drug Information |
Licence data | EMA:Link |
Pregnancy category |
|
Legal status |
|
Routes of administration |
Oral |
Identifiers | |
CAS Number | 150863-82-4 |
ATC code | L01BC53 (WHO) |
PubChem | CID: 54715158 |
The combination drug tegafur/gimeracil/oteracil (trade name Teysuno, and TS-1 in Japan[1]), also known as S-1,[2] is used for the treatment of advanced gastric cancer.[3] It is labelled for use in combination with cisplatin in many European countries, and for head and neck cancer, colorectal cancer, non–small-cell lung, breast, pancreatic, and biliary tract cancers in several countries in Asia.[4]:213 It has not been approved by the FDA.[4]:213
It is also being developed for the treatment of hepatocellular carcinoma.[5] and has activity in esophageal,(Perry Chapter 33) breast,[citation needed] cervical,[citation needed] and colorectal cancer.[6]
Within the medication, the molar ratio of the three components (tegafur:gimeracil:oteracil) is 1:1:0.4.[7]
The maximum tolerated dose differed between Asian and Caucasian populations (80 mg/m2 and 25 mg/m2 respectively), perhaps due to differences in CYP2A6 genotype.[4]:213
Mechanism of action
Tegafur is the actual chemotherapeutic agent. It is a prodrug of the active substance fluorouracil (5-FU).
Gimeracil inhibits the degradation of fluorouracil by reversibly blocking a dehydrogenase enzyme. This results in higher 5-FU levels and a prolonged half-life of the substance.
Oteracil mainly stays in the gut because of its low permeability, where it reduces the production of 5-FU by blocking the enzyme orotate phosphoribosyltransferase. Lower 5-FU levels in the gut result in a lower gastrointestinal toxicity.[8]
References
- ↑ TS-1.jp, Taiho Pharmaceutical
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- ↑ UK Drug Information
- ↑ 4.0 4.1 4.2 Lua error in package.lua at line 80: module 'strict' not found.
- ↑ http://www.biocentury.com/BCIQ
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