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Trifluridine/tipiracil (Lonsurf®) use in metastatic colorectal cancer: efficacy outcome and toxicity in a single UK centre.

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Trifluridine/tipiracil (Lonsurf®) use in metastatic colorectal cancer: efficacy outcome and toxicity in a single UK centre.
Poster
Outcomes of treatment (including chemotherapy, chemo-RT and RT)
The National Institute for Health and Care Excellence (NICE) approved Lonsurf® as a third-line palliative option in metastatic colorectal cancer in August 2016. The RECOURSE trial (Mayer et al) reported a superior median survival of 7.1 months versus 5.3 months in placebo. We performed a retrospective analysis to ascertain real-world efficacy outcomes and toxicity data.
All patients on Lonsurf® were identified from a local database. Retrospective analysis of patient medical records, pathology results and radiological imaging was performed.
Twelve patients were treated with Lonsurf® with a median age of 58 (29-77) years. Five patients are still undergoing treatment, five stopped due to progression and two had treatment interrupted. The demographics of the patients are shown in table 1. Median WHO Performance status was 0.

The overall response rate was 0% (9/9) with all patients progressing on treatment at the time of their first assessment imaging. Kaplan Meier estimate of median progression free survival was 2.0 months (95% CI 1.6-2.4) and mean overall survival was 4.5 months (95% CI 3.1-5.8). Median survival was not reached due to short follow-up but by 4 months, 45% of patient had died.

Toxicity data using the Common Terminology Criteria for Adverse Events (CTCAE) v4.0 showed 58% (7/12) had no toxicities; lethargy in 8% (1/12), neutropenia in 17% (2/12); nausea 8%(1/12) and deranged liver functions test in 8% (1/12).

In our cohort of patients, although confounded by short follow-up; response and clinical benefit rate was 0% and mean survival was 4.5 months on Lonsurf®. This requires clarification with further follow up and extended numbers but the benefit of Lonsurf® in the real world setting would appear to be very modest.
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