Trifluridine and Tipiracil (Lonsurf) for Advanced Colorectal Cancer: Response rates and Survival Data from a UK Tertiary Cancer Centre.


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Joanna Connor1
1Clatterbridge Cancer Centre

Abstract

Background

Trifluridine and Tipiracil (Lonsurf) was approved in the UK August 2016, following the phase 3 RECOURSE trial. In previously heavily treated metastatic CRC, Lonsurf improved overall survival (OS) by 2 months and had a disease control rate of 44%. Lonsurf provided a potential valuable third line treatment for patients. It is not known how this translates to clinical outcomes outside the trial setting. We aim to review our response rates and patient survival.

Method

All patients who had received or were receiving Lonsurf for advanced CRC July 2016- September 2017 in Merseyside (UK) were identified using electronic records. Overall survival (OS) was defined as the time from initiation of Lonsurf to death from any cause.  Rate of disease control (DC) was defined as the proportion of patients with complete or partial response, or stable disease at first follow up imaging. The 30 day mortality was defined as death within 30 days of receiving Lonsurf.

Results

54 patients have been treated in the 15 month period.  56% of patients were ˃65 years of age and 83% of patients had a performance status (PS) of ≤1. The average number of previous systemic treatments was 2.16 (range 1-3) and the mean number of cycles of Lonsurf received was 3.5 (range 1-11). 33.3% of patients received more than 3 cycles. OS was 5.1 months and rate of DC was 25%. The 30 day mortality was 3.7%.

Conclusion

Patients were less heavily pre-treated than the RECOURSE trial (60% ≥4 prior lines). The average duration of treatment was similar. The rate of DC was lower than expected, in keeping with better PS and preselected patients in a trial setting. OS was modest and only 20% of our patients were alive at the 6 month follow up. Despite the low OS our 30 day mortality reflected appropriate cessation of chemotherapy.