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The combination of streptozotocin and fluorouracil (often abbreviated as STZ/5FU) is a chemotherapy regimen primarily used in the treatment of advanced or metastatic pancreatic neuroendocrine tumors (pNETs). Streptozotocin is a nitrosourea antineoplastic agent that selectively targets pancreatic beta cells via the GLUT2 transporter, leading to DNA alkylation and cell death. Fluorouracil is a pyrimidine analog that inhibits thymidylate synthase, disrupting DNA synthesis and function, and can also be incorporated into RNA, interfering with RNA processing. This combination has been established as an effective first-line therapy for pNETs since the 1980s, showing durable responses and acceptable toxicity profiles[1][3][4][5].
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