UFT and S-1 for treatment of primary lung cancer.

Abstract

UFT and S-1 are oral 5-fluorouracil (5-FU) derivative drugs containing an inhibitor of dihydropyrimidine dehydrogenase (DPD); they are defined as DPD-inhibitory fluoropyrimidine (DIF). Because DPD is the key enzyme of 5-FU degradation, 5-FU is not active in primary lung cancers with high DPD activity, which causes rapid degradation of 5-FU. Thus, theoretically, a DIF can overcome a cancer's resistance to 5-FU through inhibiting the enzyme activity of DPD, with the result that 5-FU may be active in primary lung cancer. In fact, UFT has proved to be effective in a postoperative adjuvant setting for early non-small-cell lung cancer (NSCLC) in several randomized controlled studies (RCTs). S-1, in which a more potent DPD inhibitor is combined, is active in advanced NSCLC regardless of the histological cell subtype, and its clinical efficacy in first-line therapy for unresectable advanced disease as well as in postoperative adjuvant therapy for resected disease is now being examined in a variety of RCTs. In the present review, the mechanism of action of UFT and S-1 as well as clinical evidence regarding their use in the treatment of NSCLC are summarized.

• Authors: Fumihiro Tanaka, Hiromi Wada, Masakazu Fukushima
• Journal: General thoracic and cardiovascular surgery (Gen Thorac Cardiovasc Surg) Vol. 58 Issue 1 Pg. 3-13 (Jan 2010) ISSN: 1863-6713 [Electronic] Japan
• PMID: 20058135 (Publication Type: Journal Article, Review)

Chemical References

• Antineoplastic Agents
• Drug Combinations
• Enzyme Inhibitors
• UFT(R) drug
• S 1 (combination)
• Tegafur
• Uracil
• Oxonic Acid
• Dihydrouracil Dehydrogenase (NADP)

Topics

• Administration, Oral
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Carcinoma, Non-Small-Cell Lung (drug therapy, enzymology, mortality, pathology)
• Chemotherapy, Adjuvant
• Dihydrouracil Dehydrogenase (NADP) (antagonists & inhibitors)
• Drug Combinations
• Drug Resistance, Neoplasm
• Enzyme Inhibitors (therapeutic use)
• Evidence-Based Medicine
• Humans
• Lung Neoplasms (drug therapy, enzymology, mortality, pathology)
• Oxonic Acid (administration & dosage, adverse effects, therapeutic use)
• Radiotherapy, Adjuvant
• Tegafur (administration & dosage, adverse effects, therapeutic use)
• Time Factors
• Treatment Outcome
• Uracil (administration & dosage, adverse effects, therapeutic use)