Treatment Name: Trifluridine and Tipiracil (Lonsurf®)
Trifluridine and Tipiracil (Lonsurf®) is a Chemotherapy Regimen for Colon Cancer
How does trifluridine and tipiracil (Lonsurf®) work?
Trifluridine is designed to kill or slow the growth of colong cancer cells. Tipiracil slows down the body’s ability to break down trifluridine, which allows it to stay in the body longer and affect more colon cancer cells.
Goals of therapy:
Trifluridine and tipiracil is taken to shrink colon tumors or decrease symptoms of colon cancer and is not commonly given with the goal of cure.
- Usual starting dose: three to four oral tablets by mouth twice daily on Days 1, 2, 3, 4, 5 and then on Days 8, 9, 10, 11, and 12
- Take each dose within one hour after a meal (breakfast and dinner)
- You may have to take two different strength tablets to get your correct dose. Be sure to check that you are taking the correct amount of tablets of each strength before taking each dose
Each trifluridine and tipiracil cycle is repeated every 28 days. Treatment is taken until it no longer works or until unacceptable side effects occur.
Trifluridine and tipiracil must be dispensed by a specialty pharmacy and is taken at home.
In clinical studies, the most commonly reported trifluridine and tipiracil (Lonsurf®) side effects are shown here:
- Low red blood cells [Anemia] (77%)
- Low white blood cells [Neutropenia] (67%)
- Nausea (48%)
- Low platelets [Thrombocytopenia] (42%)
- Decreased appetite (39%)
- Increased bilirubin in the blood [sign of liver injury] (36%)
- Fatigue (35%)
- Diarrhea (32%)
- Increase in liver enzymes in blood [sign of liver injury] (24-30%)
- Vomiting (28%)
- Abdominal pain (21%)
- Fever (19%)
- Weakness (18%)
- Increase creatinine in blood [sign of kidney injury] (13%)
- Mouth sores (8%)
- Neutropenic fever (4%)
- Redness, blisters, and skin peeling on palms of hands and soles of feet (2%)
On average, 4% of patients discontinue Lonsurf treatment due to unacceptable side effects.
How often is monitoring needed?
Labs (blood tests) may be checked before starting each Lonsurf cycle and on Day 15 of each cycle. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before Lonsurf treatment then approximately every 8 weeks. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue trifluridine and tipiracil as planned, reduce the dose of future treatments, delay the next dose until the side effect goes away, or switch to an alternative therapy.
- Your dose is calculated based on your weight and you may have to take two different strength tablets to get your total Lonsurf dose. Read the labeling carefully to be sure that you are taking the correct amount of Lonsurf tablets of each strength
- Patients who are 65 years of age or older may experience low red blood cells, white blood cells, and platelets more often compared to patients younger than 65 years
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for colon cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Trifluridine and Tipiracil (Lonsurf®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Trifluridine and Tipiracil (Lonsurf®). Depending upon your income, they may be able to help cover the cost of:
- Trifluridine and Tipiracil
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Trifluridine and Tipiracil (Lonsurf®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Trifluridine and Tipiracil (Lonsurf®)