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The combination "capecitabine + oxaliplatin + S-1 + oxaliplatin + folinic acid + fluorouracil + oxaliplatin" refers to the pooled standard-of-care comparator arm used in the FNF-014 (NCT03788226) Phase III clinical trial. This arm represents three clinician-selected doublet chemotherapy regimens: CAPOX (capecitabine and oxaliplatin), SOX (S-1 and oxaliplatin), and FOLFOX (folinic acid, 5-fluorouracil, and oxaliplatin). These regimens are used as postoperative adjuvant chemotherapy for patients with curatively resected pathological stage III gastric adenocarcinoma or gastroesophageal junction adenocarcinoma. The active components function as cytotoxic agents: oxaliplatin is a platinum-based compound that causes DNA crosslinking, while capecitabine, S-1, and 5-fluorouracil are antimetabolites that inhibit thymidylate synthase (TS). Folinic acid (leucovorin) is included to stabilize the binding of 5-FU to TS, enhancing its efficacy. S-1 is a multi-component oral fluoropyrimidine consisting of tegafur (a 5-FU prodrug), gimeracil, and oteracil. The trial, sponsored by Fujian Provincial Cancer Hospital, compares these standard regimens against an experimental triplet regimen known as POF (paclitaxel, oxaliplatin, folinic acid, and 5-FU).
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