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PD-1 inhibitor + SOX chemotherapy refers to a combination immunotherapy and chemotherapy regimen primarily utilized in the treatment of locally advanced gastric and gastroesophageal junction (GEJ) adenocarcinoma. The regimen consists of a programmed cell death protein 1 (PD-1) blocking monoclonal antibody—most notably **tislelizumab** (also known as tirellizumab) in recent clinical trials—combined with the SOX chemotherapy doublet, which includes **S-1** (a multi-component oral fluoropyrimidine) and **oxaliplatin**. The mechanism of action involves the PD-1 inhibitor restoring T-cell mediated anti-tumor immunity by preventing the interaction between PD-1 and its ligands (PD-L1/PD-L2), while the SOX components provide cytotoxic effects: oxaliplatin induces DNA cross-linking and S-1 inhibits thymidylate synthase to disrupt DNA synthesis. This combination is frequently evaluated as a neoadjuvant therapy to increase major pathological response (mPR) rates and improve surgical outcomes in patients with resectable gastric cancers.
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