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This combination therapy regimen consists of the multi-kinase inhibitor sorafenib, the platinum-based chemotherapeutic oxaliplatin, and the oral fluoropyrimidine S-1 (a fixed-dose combination of tegafur, gimeracil, and oteracil). It is being investigated by Zhejiang University as an adjuvant therapy to prevent the recurrence of hepatocellular carcinoma (HCC) in patients following liver transplantation. Sorafenib acts by inhibiting various kinases including VEGFR, PDGFR, and Raf, which are involved in tumor angiogenesis and cell proliferation. Oxaliplatin induces cytotoxic effects by forming DNA cross-links, thereby inhibiting DNA replication and transcription. S-1 is designed to provide sustained levels of 5-fluorouracil (5-FU) via the prodrug tegafur, while gimeracil inhibits the degradation of 5-FU and oteracil reduces its gastrointestinal toxicity. This triple-drug approach aims to provide comprehensive anti-tumor activity through multiple distinct mechanisms.
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