Complete response of early gastric cancer to uracil and tegafur

Combination Use of Tegafur and Apatinib as First-Line Therapy in Treatment of Advanced Gastric Cancer: A Single-Blinded Randomized Study

Objective

To investigate the efficacy and safety of the combination use of tegafur and apatinib as a first-line therapy strategy in advanced gastric cancer (GC).

Methods

The present study included a total of 62 advanced GC patients. The patients were randomized into the combined group (treated with both tegafur and apatinib) and the control group (treated with only tegafur). Treatment efficacy, KPS score, nutrition condition, and progression-free survival time (PFS) were recorded.

Results

Both the response and disease control rates were significantly higher in the combined group. The PFS time was remarkably higher and the KPS score was significantly reduced in the combined group after treatment. After treatment, both groups showed significantly increased nutrition risk, but the rates of patients with nutrition risk or innutrition were remarkably higher in the combined group. The ADR rates were also significantly higher in the combined group.

Conclusion

The combination use could achieve good efficacy and prolong patients' PFS time; however, apatinib also reduced the patients' quality of life and enhanced the nutrition risk and adverse drug reactions.

Polyethylenimine-cyclodextrin-tegafur conjugate shows anti-cancer activity and a potential for gene delivery

Polyethylenimine-cyclodextrin-tegafur (PEI-CyD-tegafur) conjugate was synthesized as a novel multifunctional prodrug of tegafur for co-delivery of chemotherapeutic agent tegafur and enhanced green fluorescent protein (EGFP) reporter plasmid DNA. Conjugation of tegafur to PEI-CyD via chemical linkage was characterized by (1)H NMR spectrometry and ultraviolet (UV) spectrometry. PEI-CyD-tegafur was able to condense plasmid DNA into complexes of around 150 nm with positive charge at the N/P ratio of 25, in accordance with electron microscopy observation of compact and monodisperse nanoparticles. The results of in vitro experiments showed enhanced cytotoxicity and considerable transfection efficiency in B16F10 cell line. Therefore, PEI-CyD-tegafur may have great potential as a co-delivery system with anti-cancer activity and potential for gene delivery.

Complete response of a gastric primary after a short but toxic course of 'S-1' EORTC Early Clinical Studies Group

We report the case of an unresected, metastatic gastric cancer, which was treated with a very short course of the oral 5-fluorouracil (5-FU) prodrug S-1. The patient had to discontinue chemotherapy during the first treatment cycle due to severe toxicity, but achieved a pathologically confirmed, long-term complete response of her primary tumour, a diffuse-type poorly differentiated adenocarcinoma.

Novel chemotherapeutic agents for gastrointestinal cancers

Although 5-fluorouracil has been the most commonly prescribed chemotherapy agent in the treatment of patients with gastrointestinal malignancies, new agents discussed herein provide options for the treatment of patients with colorectal, gastric, and pancreas cancer. Irinotecan was recently approved for the treatment of patients with colorectal cancer refractory to 5-fluorouracil. It has also been evaluated in chemotherapy-naïve patients both alone and in combination with 5-fluorouracil plus leucovorin or with oxaliplatin. Evaluated primarily in patients with colorectal cancer, oxaliplatin, a novel platinum compound, is an active agent. In combination with 5-fluorouracil and leucovorin, oxaliplatin provides a higher response rate than 5-fluorouracil and leucovorin alone. Furthermore, when oxaliplatin was added to the same 5-fluorouracil-based regimen in which patients had disease progression, clinical activity was observed. Other agents discussed herein are raltitrexed and the oral fluorinated pyrimidines, including uracil:tegafur plus leucovorin, capecitabine, eniluracil plus oral 5-fluorouracil, and S-1. Gemcitabine has been demonstrated to be more effective than 5-fluorouracil in the alleviation of disease-specific symptoms in patients with advanced pancreatic cancer. Gemcitabine also confers a modest survival advantage. Combinations of these novel compounds are evaluated in gastrointestinal malignancies in the advanced disease setting and in adjuvant therapy programs.