Trifluridine/tipiracil: A practical guide to its use in the management of refractory metastatic colorectal cancer in Australia.


Journal

Asia-Pacific journal of clinical oncology
ISSN: 1743-7563
Titre abrégé: Asia Pac J Clin Oncol
Pays: Australia
ID NLM: 101241430

Informations de publication

Date de publication:
Apr 2020
Historique:
entrez: 30 4 2020
pubmed: 30 4 2020
medline: 15 7 2020
Statut: ppublish

Résumé

Trifluridine/tipiracil is available on the Australian Pharmaceutical Benefits Scheme for the treatment of patients with metastatic colorectal cancer (mCRC) previously treated with, or not considered candidates for, fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies, anti-vascular endothelial growth factor agents and anti-epidermal growth factor receptor agents. This article reviews trifluridine/tipiracil clinical data and presents practical information on its use in the management of refractory mCRC in Australia. Whereas the primary mechanism of action of fluoropyrimidines such as fluorouracil (5-FU) and capecitabine is enzyme inhibition of nucleotide synthesis, trifluridine/tipiracil primarily acts by incorporation into DNA, resulting in DNA dysfunction. Trifluridine/tipiracil has activity in patients with 5-FU-resistant tumors and can be considered in patients with prior intolerance or toxicity to 5-FU. In the pivotal phase III RECOURSE trial evaluating trifluridine/tipiracil in chemotherapy-refractory mCRC, efficacy benefits were observed across all a priori prognostic subgroups including those defined by age (≥65 and ≥75 years), geographical origin, primary tumor site or KRAS status. Trifluridine/tipiracil therapy benefits appropriately selected patients who have an ECOG performance status of 0 or 1, with no more than mild hepatic impairment or mild-to-moderate renal impairment, and who are capable of adhering to oral therapy safely. Appropriate dosing, monitoring for adverse events and effective management of side effects are essential.

Identifiants

pubmed: 32348018
doi: 10.1111/ajco.13336
doi:

Substances chimiques

Drug Combinations 0
Pyrrolidines 0
trifluridine tipiracil drug combination 0
Uracil 56HH86ZVCT
Thymine QR26YLT7LT
Trifluridine RMW9V5RW38

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3-12

Informations de copyright

© 2020 John Wiley & Sons Australia, Ltd.

Références

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Auteurs

Timothy Price (T)

The Queen Elizabeth Hospital, Woodville, SA, Australia.

Matthew Burge (M)

Royal Brisbane Hospital, University of Queensland, QLD, Australia.

Lorraine Chantrill (L)

Illawarra Shoalhaven Local Health District, Illawarra Cancer Care Centre, Wollongong Hospital, NSW, Australia.
University of New South Wales Sydney, NSW, Australia.
The Garvan Institute of Medical Research, Sydney, NSW, Australia.

Peter Gibbs (P)

Walter and Eliza Hall Institute, Parkville, VIC, Australia.
University of Melbourne, Parkville, VIC, Australia.
Western Hospital, Footscray, VIC, Australia.

Nick Pavlakis (N)

Royal North Shore Hospital, Sydney, NSW, Australia.

Jeremy Shapiro (J)

Cabrini Hospital, Melbourne, VIC, Australia.
Monash University, Melbourne, VIC, Australia.

Katrin Sjoquist (K)

NHMRC Clinical Trials Centre, University of Sydney, NSW, Australia.
Cancer Care Centre, St George Hospital, Sydney, NSW, Australia.

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