S-1 Maintenance Chemo

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Siti
Posts: 269
Joined: Thu Aug 01, 2019 10:58 am

S-1 Maintenance Chemo

Postby Siti » Fri Apr 24, 2020 7:52 am

Hello everyone,

Wanted to pick your brain. My husband is still at the hospital getting his Avastin infusion as we speak but with a little surprise our oncologist has suggested to switch capecitabine to S-1 due to hands and feet side effects.

He said that it works the same was as capecitabine without the H&F side effects. I have not read much about this drug and how it works, so I’m quite concerned trying something new during this chaos. Surveillance CT scan is due in 2.5 weeks.

Any thoughts?

Thanks in advance :)

Siti
DH (54) DX on 5/7/19
Sigmoid|G3|LN:30/31|MSS|WT KRAS, NRAS, BRAF
7/19 PET distant LN para-aorta neck hip (0.5-1.5cm)
7/19 Lap resection
26/8 to 20/12/19 CAPEOX+Bev 7x
6/11/19 CT 3 cycle LN shrunk
1/20 Cap+Bev
4/20 TS-1+Bev due to bad HFS
NED 4 years
8/23 PET recurrence chest LN growing since Feb. CEA May(4.5>5.1>5.9)
9/23 Stopped Bev, CEA Sept(8.7) Radio 17x
11/23 PET 1+ supraclavicular LN, CEA (3.4>2.5)
12/23 Lymphadenectomy
1/24 Narrow margins, 1/5 +LN, 1.4cm +tissue, TMB (19)

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: S-1 Maintenance Chemo

Postby rp1954 » Tue Apr 28, 2020 1:49 am

I'll answer here. My wife took UFT, tegafur - uracil, every day for 8 years, along with a lot of other chemistry, hand fit for her with a lot of observation, blood and tissue work. Uracil is a mild competitive inhibitor for fluorouracil; UFT is a milder drug dosed as daily immunochemo TID, as developed in Japan. Across the years, we modulated UFT's immunochemo inhibition properties with celecoxib, cimetidine, leucovorin, aspirin, menatetrenone, beta glucans and other immune modulating powders, flavonoids, IV vitamin C, various natural anti-inflammatories and essential nutrients, sometimes in large doses.

S-1 is tegafur with a pair of chemicals that are potent, irreversible inhibitors. In 2010-2011, I got the impression that S-1 is hard to finely dose and has more side effects, typically dosed with more immune damage for limited periods of treatment time. Oncologists may have gotten better at that over a dozen years since startup. I have not seen experience reported on how much S-1's effects might be modulated and ameliorated by careful metronomic dosing and nutraceutical treatments.

A lot of nutraceutical uses overlap between cancer and viral support but again no insight on S-1's special, irreversible inhibitors. With the other 5FU drugs, overlaps that I've seen or heard of include:
megadose vitamin D3 (with menaquinone-4 and magnesium), IV vitamin C (sometimes with slow release, oral potassium), zinc, quercetin, resveratrol, melatonin and beta glucans. Apparently CV19 depletes potassium as well as some of the controversial generic drugs with QTc elongation, so tests that don't control potassium and magnesium blood levels by monitoring, and repletion as necessary, are "wasteful" and less informative...

One might also suspect CV19's nasty microclot coagulation derangement to be partly associated with depleted ascorbate, zinc and flavonoids.

This doctor's prophylatic regimin is much lower than a more nutraceutically oriented approach might, but is remarkable for a mainstream EBM approach.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

Siti
Posts: 269
Joined: Thu Aug 01, 2019 10:58 am

Re: S-1 Maintenance Chemo

Postby Siti » Wed Apr 29, 2020 3:53 am

rp1954 wrote:In 2010-2011, I got the impression that S-1 is hard to finely dose and has more side effects, typically dosed with more immune damage for limited periods of treatment time. Oncologists may have gotten better at that over a dozen years since startup. I have not seen experience reported on how much S-1's effects might be modulated and ameliorated by careful metronomic dosing and nutraceutical treatments.

A lot of nutraceutical uses overlap between cancer and viral support but again no insight on S-1's special, irreversible inhibitors.


Thank you for your reply :)

We’re aware that dosing is different for Asians vs Caucasians for some reason. My husband is Caucasian, our oncologist has given him max dose, 120mg per day — 3x white capsules (20mg) each in the morning and evening— his surface area is 2m. It seems a bit high but hey I’m not the doctor. His cycle is same as capecitabine (2 weeks on 1 week off), again seem different from the 4 weeks on and 2 weeks off which I read.

As for your second statement, what does irreversible inhibitors mean?
DH (54) DX on 5/7/19
Sigmoid|G3|LN:30/31|MSS|WT KRAS, NRAS, BRAF
7/19 PET distant LN para-aorta neck hip (0.5-1.5cm)
7/19 Lap resection
26/8 to 20/12/19 CAPEOX+Bev 7x
6/11/19 CT 3 cycle LN shrunk
1/20 Cap+Bev
4/20 TS-1+Bev due to bad HFS
NED 4 years
8/23 PET recurrence chest LN growing since Feb. CEA May(4.5>5.1>5.9)
9/23 Stopped Bev, CEA Sept(8.7) Radio 17x
11/23 PET 1+ supraclavicular LN, CEA (3.4>2.5)
12/23 Lymphadenectomy
1/24 Narrow margins, 1/5 +LN, 1.4cm +tissue, TMB (19)


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