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Teysuno (S-1) is an oral chemotherapy combining a fluorouracil pro-drug with two protectors. It is a standard in Japan and approved in Europe for stomach cancer with cisplatin and for bowel cancer when other fluoropyrimidines cause hand-foot syndrome or heart problems.
S-1 has been a mainstay of gastric, pancreatic, colorectal and lung cancer treatment in Japan since 1999 (ACTS-GC established adjuvant S-1 in gastric cancer). The European Commission authorised Teysuno in March 2011 for advanced gastric cancer with cisplatin, on the FLAGS trial in which S-1 plus cisplatin was non-inferior to fluorouracil plus cisplatin with less toxicity, and in 2022 for metastatic colorectal cancer as monotherapy or with oxaliplatin or irinotecan, with or without bevacizumab, in patients who cannot continue another fluoropyrimidine because of hand-foot syndrome or cardiovascular toxicity. Because Western patients metabolise tegafur faster through CYP2A6 polymorphisms, doses differ from Japan. It is not approved in the US, where a trial of S-1 versus fluorouracil failed to show superiority. Diarrhoea, neutropenia and stomatitis are the main toxicities.
Tegafur is a fluorouracil prodrug; gimeracil inhibits dihydropyrimidine dehydrogenase to sustain fluorouracil levels, and oteracil blocks phosphorylation of fluorouracil in the gut to reduce diarrhoea.
1.Tegafur, gimeracil and oteracil (S-1) slips into a pocket on its target.
Compare all products across the US, EU, UK, Japan, China and Australia →
| Region | Year | Indication |
|---|---|---|
| JP | 1999 | Gastric cancer; later colorectal, head and neck, lung, pancreatic, biliary and breast cancer (TS-1) |
| EU | 2011 | Advanced gastric cancer with cisplatin; metastatic colorectal cancer intolerant of other fluoropyrimidines added 2022 (Teysuno) |
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Query for this drug: (TITLE:"Tegafur, gimeracil and oteracil" OR ABSTRACT:"Tegafur, gimeracil and oteracil" OR TITLE:"S-1" OR ABSTRACT:"S-1" OR TITLE:"Teysuno" OR ABSTRACT:"Teysuno" OR TITLE:"TS-1" OR ABSTRACT:"TS-1") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Tegafur, gimeracil and oteracil (S-1), not a curated reading list.
Shares JASPAC 01, Resectable pancreatic ductal adenocarcinoma, Capecitabine, Pancreatic ductal adenocarcinoma.
Shares Fluorouracil (5-FU), Capecitabine, Gastric & gastro-oesophageal junction cancer, Cytotoxic chemotherapy.
Shares JASPAC 01, Resectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma, Cytotoxic chemotherapy.
Shares HR070803 in Combination With Oxaliplatin, S-1 Versus NALIRIFOX as Adjuvant Therapy for Pancreatic Cancer, Liposomal Irinotecan in Combination With Oxaliplatin and S-1 Versus Gemcitabine Combined With Capecitabine as Postoperative Adjuvant Therapy for Pancreatic Canc, Gallbladder cancer, Pancreatic ductal adenocarcinoma.
Shares Fluorouracil (5-FU), Capecitabine, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
Shares Resectable pancreatic ductal adenocarcinoma, Fluorouracil (5-FU), Metastatic pancreatic ductal adenocarcinoma, Cytotoxic chemotherapy.
Shares Fluorouracil (5-FU), Metastatic pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma, Cytotoxic chemotherapy.
Shares Taiho Pharmaceutical (Otsuka), Cytotoxic chemotherapy, Colorectal cancer.