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Tegafur + temozolomide + thalidomide is an investigational combination chemotherapy and anti-angiogenic regimen evaluated for the treatment of advanced neuroendocrine tumors (NETs). The regimen, often referred to as the STEM regimen, incorporates S-1 (a combination of the 5-fluorouracil prodrug tegafur with gimeracil and oteracil), the oral alkylating agent temozolomide, and the immunomodulatory drug thalidomide. It was primarily studied in the Phase II STEM trial conducted by the Cancer Institute and Hospital, Chinese Academy of Medical Sciences. The combination aims to improve outcomes in patients with pancreatic and non-pancreatic NETs by combining cytotoxic DNA damage and antimetabolite activity with the suppression of tumor angiogenesis and cell proliferation.
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