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This is a four-drug combination regimen consisting of docetaxel, oxaliplatin, S-1 (an oral fluoropyrimidine), and durvalumab (a PD-L1 immune checkpoint inhibitor). The combination has been investigated as neoadjuvant therapy for resectable locally advanced gastric cancer (LAGC), particularly in Asian populations. Mechanistically, docetaxel and oxaliplatin are cytotoxic chemotherapeutic agents that disrupt cell division; S-1 is an oral prodrug of 5-fluorouracil with modulators to enhance efficacy and reduce gastrointestinal toxicity; and durvalumab is a monoclonal antibody that blocks the interaction between PD-L1 and its receptors, enhancing anti-tumor immune responses. This regimen aims to combine the cytotoxic effects of chemotherapy with immunotherapy to improve pathological complete response rates prior to surgery. Clinical studies have shown promising efficacy and manageable safety profiles in this setting[1][2][3].
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