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S-1 + PSK is a combination therapy used primarily in the treatment of advanced gastric cancer. S-1 is an oral anticancer drug composed of three pharmacological compounds—tegafur (a prodrug of fluorouracil), gimeracil (an inhibitor of dihydropyrimidine dehydrogenase), and oteracil potassium (an inhibitor that reduces gastrointestinal toxicity)—formulated to enhance the efficacy and reduce the side effects associated with 5-fluorouracil chemotherapy[2][4]. PSK (polysaccharide K or protein-bound polysaccharide K) is a biological response modifier derived from the mushroom Coriolus versicolor and acts as an immunomodulator. The combination aims to improve both cytotoxic activity against tumor cells via inhibition of DNA synthesis (from S-1) and enhance immune response through modulation of immune cell populations such as natural killer cells and regulatory T cells by PSK[1][3]. Clinical studies suggest that adding PSK to adjuvant chemotherapy regimens can improve overall survival in patients with gastric cancer after surgery[3].
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