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S-1 + epirubicin + oxaliplatin is a combination chemotherapy regimen primarily investigated for the treatment of advanced or metastatic gastric and esophagogastric cancer. S-1 is an oral fluoropyrimidine consisting of tegafur (a prodrug of 5-fluorouracil), 5-chloro-2,4-dihydroxypyridine (a dihydropyrimidine dehydrogenase inhibitor that prolongs 5-FU exposure), and oteracil potassium (which reduces gastrointestinal toxicity). Epirubicin is an anthracycline antineoplastic that intercalates DNA and inhibits topoisomerase II. Oxaliplatin is a platinum-based agent that forms DNA crosslinks, resulting in apoptosis. This combination leverages the distinct mechanisms of each agent for enhanced antitumor efficacy, particularly in first-line palliative therapy of advanced gastric cancers[1][3][2][4].
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