S-1, a series of strategies to fight against tumors

The 29th National Cancer Prevention and Treatment Week

April 15-21

The chain strategy comes from the 35th strategy of the Thirty-Six Stratagems, which is to use multiple strategies in succession, one after another. Just like in the Romance of the Three Kingdoms, Pang Tong suggested that Cao Cao connect the warships with iron rings to lock the ships, which led to the fire attack in the Battle of Red Cliffs. The warships connected by the iron rings caught fire one after another, resulting in a great defeat.

The anti-tumor drug "Tegafur" perfectly illustrates this strategy. Tegafur is an oral preparation composed of three ingredients, "Tegafur", "Gimeracil" and "Oteracil Potassium" in a molar ratio of 1:0.4:1. It can be used clinically to treat gastric cancer, breast cancer, non-small cell lung cancer, colon cancer and other tumors. After Tegafur is taken orally into the human body, it begins to perform the first trick of the chain plan - Tegafur removes the prodrug disguise and slowly transforms into fluorouracil in the body to exert its anti-tumor effect. Fluorouracil directly destroys tumor cells by affecting tumor DNA synthesis, and kills tumors in the body. The second trick of the chain plan - Gimeracil inhibits the decomposition enzyme dihydropyrimidine dehydrogenase (DPD) in the body that affects fluorouracil, thereby increasing the concentration of fluorouracil released by the "general" Tegafur, making Tegafur even more lethal. As the saying goes, "All medicines are three-point poisonous", and the same is true for anticancer drugs. While Tegafur releases fluorouracil in the body to kill people like crazy, it also causes damage to normal cells in the body, just as the saying goes, "killing one thousand enemies will hurt eight hundred of your own", especially to gastrointestinal cells. At this time, the oteracil potassium in Tegafur uses the third strategy - stepping forward and rescuing on the front line.

After oral administration, oteracil potassium is distributed in the gastrointestinal tract, and selectively inhibits the conversion of fluorouracil into 5-fluoronucleotides by reducing the activity of orotate phosphoribosyltransferase. 5-fluoronucleotides are substances that cause gastrointestinal toxicity and are the cause of fluorouracil-induced gastrointestinal adverse reactions such as diarrhea and mucositis. Oteracil potassium is like a shield, blocking the gastrointestinal cells of the human body, protecting the gastrointestinal tract from damage without affecting the anti-tumor activity of fluorouracil.

The three strategies are closely linked. After entering the human body, "Ti-Gio-Ao" play a synergistic role. They are complementary to each other in anti-tumor, assisting in increasing drug concentration, and reducing toxic and side effects. As the ancient text of the chain of strategies says: "One strategy is to tire the enemy, one strategy is to attack the enemy, and two strategies are used together to destroy the strong." In ancient times, Pang Shiyuan used two strategies to break the strong boat, and now there are three strategies of Ti-Gio to fight tumors! Anti-tumor drugs must be prescribed by doctors in regular medical institutions and used reasonably under the guidance of doctors or pharmacists.