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Pembrolizumab + S-1 + oxaliplatin is a combination regimen used primarily in the first-line treatment of advanced gastric and gastroesophageal junction (G/GEJ) adenocarcinoma that is PD-L1-positive and HER2-negative. Pembrolizumab is a humanized monoclonal antibody targeting programmed death 1 (PD-1), acting as an immune checkpoint inhibitor to enhance anti-tumor immune responses. S-1 is an oral fluoropyrimidine derivative combining tegafur (a prodrug of 5-fluorouracil), gimeracil, and oteracil potassium; it acts as an antimetabolite chemotherapeutic agent inhibiting thymidylate synthase. Oxaliplatin is a platinum-based chemotherapeutic that induces DNA crosslinking and apoptosis in cancer cells. The combination has shown encouraging efficacy and manageable safety in phase IIb clinical trials for advanced G/GEJ cancer[1][2][5][7].
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