Trifluridine-Tirpiracil (LONSURF)

Gastric cancer, advanced or metastatic

Colorectal cancer, advanced or metastatic

Gastric cancer, advanced or metastatic

• Oral:  35mg/m2 (based on trifluridine component)  twice daily for days 1-5 and days 8-12 out of every 28 days until disease progression or unacceptable toxicity
• Dose should be rounded to the nearest 5 mg increment

Colorectal cancer, advanced or metastatic

• Oral: 35mg/m2 (based on trifluridine component)  twice daily for days 1-5 and days 8-12 out of every 28 days until disease progression or unacceptable toxicity
• Dose should be rounded to the nearest 5 mg increment
• Given in combination with bevacizumab

‍

Available as 15 mg-6.14 mg and 20 mg-8.19 mg tablets. Tablets contain lactose. Tablets should NOT be crushed or broken. Store tablets at room temperature.

Antimetabolite

Take with food

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: Anemia, Neutropenia, Diarrhea, Nausea, Fatigue, Infections, Appetite decrease.

Less Common: Pyrexia, Neutropenia sepsis, Interstitial lung disease, Pneumonitis, Pulmonary embolism.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, sodium, potassium, creatinine, urea, bilirubin, ALT, alkaline phosphatase, LDH, dipstick urine protein. If clinically indicated: CEA.

During treatment: CBC & differential, platelets, sodium, potassium, creatinine, urea, bilirubin, ALT, alkaline phosphatase, LDH. If clinically indicated: dipstick urine protein, CEA.

• Current drug interaction databases should be consulted for more information

• Avoid in pregnancy and lactation.
• Patients who have had prior radiotherapy may experience more hematological and myelosuppression related adverse reactions.
• The dosing schedule for this drug can be challenging for patients, adherence counselling and follow up is important.

BC Cancer. BC Cancer Drug Manual. Trifluridine-tipiracil. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Trifluridine-tipiracil_monograph.pdf. Updated May 1, 2023. Accessed May 9, 2024.

Lexicomp. Trifluridine-tipiracil Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Accessed May 9, 2024.

Cancer Care Ontario. Trifluridine/tipiracil Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/54171. Updated September 2021. Accessed May 9, 2024.