Trifluridine/Tipiracil (Lonsurf) for the Treatment of Metastatic Colorectal Cancer.
Year: 2016
Type: article
Abstract: In the United States, colorectal cancer is the third most common malignancy in both men and women, following prostate and lung/bronchus cancer in men, and breast and lung/bronchus cancer in women.1 The American Cancer Society predicts that more than 130,000 new cases of colorectal cancer will be diagnosed in 2016 and that 49,000 people will die from the disease.1 Five-year survival rates for colorectal cancer diagnosed at the local stage are 90%, but that survival rate drops to 13% for those diagnosed with metastatic disease. Approximately 20% of patients are diagnosed at the metastatic stage. Among patients diagnosed at earlier stages, 50% to 60% eventually go on to develop colorectal metastases.2,3 Initial treatment usually involves a combination of surgery, radiation, and chemotherapy tailored to the characteristics of each patient’s disease.3
Fluoropyrimidine-based therapies have served as the backbone of colorectal cancer treatment for decades, and combination-based therapies with this drug class have led to significant reductions in mortality. Unfortunately, tumor cells can develop resistance to fluoropyrimidine-mediated damage, leaving clinicians with few options for heavily pretreated patients.4 The combination of trifluridine and tipiracil (TFD/TPI) has shown clinical activity in patients resistant to 5-flurorouracil (5-FU) and offers a viable alternative for pretreated individuals with metastatic colorectal cancer. Upon administration, the TFD component is incorporated directly into the replicating DNA strand, leading to tumor-cell damage, while the TPI component inhibits the secretion of angiogenic factors and endothelial cell growth.5–7
In September 2015, the Food and Drug Administration approved TFD/TPI (Lon-surf, Taiho Oncology, Inc.) for use in patients with metastatic colorectal cancer who have been treated with fluoropyrimi-dine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti-vascular endothelial growth factor (VEGF) biological therapy, and—if RAS wild-type—an anti-epidermal growth factor receptor (EGFR) therapy.8,9
The only other medication with this indication is regorafenib (Stivarga, Bayer HealthCare), a tyrosine kinase inhibitor approved in September 2012.10,11
Source: PubMed Central
Authors: Troy Kish, Priyasha Uppal
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2358175383