tegafur + gimeracil + oteracil potassium + temozolomide

The combination of **tegafur + gimeracil + oteracil potassium + temozolomide** (commonly referred to as the STEM regimen) is an investigational oral combination chemotherapy regimen evaluated for the treatment of advanced or metastatic pancreatic and non-pancreatic neuroendocrine tumors (NETs). The regimen pairs S-1—an oral fixed-dose combination of the 5-fluorouracil (5-FU) prodrug tegafur, the dihydropyrimidine dehydrogenase (DPD) inhibitor gimeracil, and the orotate phosphoribosyltransferase (OPRT) inhibitor oteracil potassium—with the oral alkylating agent temozolomide. Tegafur is metabolized to active 5-FU, which inhibits thymidylate synthase to disrupt DNA synthesis, while gimeracil prevents 5-FU degradation and oteracil reduces gastrointestinal toxicity. Temozolomide induces DNA damage by alkylating guanine residues, which synergizes with the antimetabolite activity of 5-FU. The combination has been evaluated in the randomized Phase II STEM trial, demonstrating comparable efficacy and a manageable safety profile with or without the addition of thalidomide.

Other names

S-1 + temozolomideS-1/temozolomideSTEMSTEM regimentegafur + gimeracil + oteracil + temozolomidetegafur-gimeracil-oteracil potassium + temozolomidetegafur/gimeracil/oteracil potassium + temozolomide