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This chemotherapy regimen is a combination of cytotoxic agents used as the standard of care in the perioperative treatment of locoregional gastric and gastroesophageal junction (GEJ) adenocarcinoma. It typically consists of the platinum-based agent oxaliplatin and the fluoropyrimidine prodrug capecitabine, with the optional addition of the anthracycline epirubicin. Oxaliplatin functions by forming DNA adducts that inhibit DNA replication and transcription. Capecitabine is enzymatically converted to 5-fluorouracil, which inhibits thymidylate synthase, thereby disrupting DNA synthesis. Epirubicin intercalates into DNA and inhibits topoisomerase II, leading to DNA strand breaks. In the context of clinical trial NCT02918162 led by Dr. Gulam Manji, this regimen was evaluated in combination with the PD-1 inhibitor pembrolizumab.
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