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Currently, however, there are technical barriers in sampling human hypoxic tumors and examining drug delivery with high sensitivity and accuracy. Herein, we present a new platform combining functional endoscopy and highly sensitive liquid chromatography\u2010mass spectrometry (LC\u2013MS) to assess drug delivery to hypoxic regions. Because oxygen saturation endoscopic imaging (OXEI), a functional endoscopy, can evaluate lesions and hypoxia in real\u2010time by simultaneously acquiring a pseudocolor map of oxygen saturation and conventional endoscopic images, this platform can be used to evaluate drug delivery with human samples from hypoxic regions. As the first clinical application of this platform, the relationship between hypoxic regions and the concentration of trifluridine (FTD) incorporated into DNA was evaluated in patients with advanced gastric cancer treated with FTD\/tipiracil (FTD\/TPI; <jats:italic>n<\/jats:italic>\u2009=\u200913) by obtaining and analysis of tissue samples by OXEI and LC\u2013MS and vascular maturity index by CD31\/\u03b1\u2010SMA staining <jats:italic>ex vivo<\/jats:italic>. The results showed that the concentration of FTD was significantly higher in the normoxic region than in the hypoxic region (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) and there were significantly more immature vessels in hypoxic regions than in normoxic regions (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). These results indicate that the platform was sufficiently sensitive to evaluate differences in drug anabolism in different oxygenic regions of human tumor tissue. This new platform allows quantitative drug analysis in hypoxic regions and is expected to initiate a new era of drug discovery and development.<\/jats:p>","DOI":"10.1002\/cpt.3066","type":"journal-article","created":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T04:51:35Z","timestamp":1696654295000},"page":"62-70","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Quantitative Analysis of the Concentration of Trifluridine in Tumor Hypoxic Regions Using a Novel Platform Combining Functional Endoscopy and Mass Spectrometry"],"prefix":"10.1002","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1323-4896","authenticated-orcid":false,"given":"Shigehiro","family":"Koganemaru","sequence":"first","affiliation":[{"name":"Department of Experimental Therapeutics National Cancer Center Hospital East  Kashiwa 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