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01.03.2012 | Original Article | Ausgabe 3/2012

Cancer Chemotherapy and Pharmacology 3/2012

Effect of food and a proton pump inhibitor on the pharmacokinetics of S-1 following oral administration of S-1 in patients with advanced solid tumors

Cancer Chemotherapy and Pharmacology > Ausgabe 3/2012
Max E. Scheulen, Kaku Saito, Ralf A. Hilger, Bastian Mende, Christopher Zergebel, Dirk Strumberg



S-1 is a novel oral fluoropyrimidine comprised of FT and two modulators, gimeracil (CDHP) and oteracil potassium (Oxo). This study investigated the food effects on the pharmacokinetics (PK) of Oxo, other components of S-1, and their metabolites at different gastric pH adjusted by proton pump inhibitor (PPI).


Patients with and without PPI were treated with S-1 at 30 mg/m2 twice daily orally on days 1–7 under either fed or fasting condition, and then were crossed over to fasting/fed conditions on days 15–21 with washout on days 8–14 and 22–28.


The study enrolled 55 patients including 27 PK-evaluable patients. For the single-dose and multiple-dose pharmacokinetics, the administration of S-1 under fed conditions resulted in decreased exposure to Oxo relative to fasting administration. There was a marginal decrease in exposure to CDHP and 5-FU under fed versus fasting conditions, although FT exposure was not altered by food, which demonstrated lack of food effect. PPI administration together with S-1 did not significantly change its bioavailability.


Oxo exposure was reduced under fed compared to fasting condition. To increase the bioavailability of S-1, the administration of S-1 under fasting condition was more effective in the western countries.

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