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S-1 + oxaliplatin is a combination chemotherapy regimen used primarily for the treatment of advanced or metastatic gastrointestinal cancers such as gastric and colorectal cancer. S-1 is an oral fluoropyrimidine derivative composed of tegafur (a prodrug of 5-fluorouracil), gimeracil (an inhibitor of dihydropyrimidine dehydrogenase to increase 5-FU bioavailability), and oteracil (to reduce gastrointestinal toxicity). Oxaliplatin is a platinum-based alkylating agent that exerts its antitumor effect by forming DNA crosslinks—both interstrand and intrastrand—thereby inhibiting DNA replication and transcription. The combination leverages the cytotoxic effects of both agents to improve efficacy against rapidly dividing tumor cells[2][3][5][6].
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