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The combination of cisplatin, irinotecan, and capecitabine refers to a set of chemotherapy agents evaluated by Johannes Gutenberg University Mainz in a Phase II clinical trial (NCT00273949) for the treatment of advanced gastric cancer and gastroesophageal junction (GEJ) adenocarcinoma. The study specifically compared two doublet regimens: capecitabine plus irinotecan (XI) and capecitabine plus cisplatin (XP). Cisplatin is a platinum-based antineoplastic agent that forms covalent DNA adducts, leading to intra-strand and inter-strand cross-links that inhibit DNA replication and transcription. Irinotecan is a topoisomerase I inhibitor that stabilizes the cleavable complex between the enzyme and DNA, resulting in double-strand DNA breaks during replication. Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) that is converted to its active form within tumor tissue, where it inhibits thymidylate synthase, thereby disrupting pyrimidine synthesis and DNA repair.
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