Trifluridine, tipiracil (Lanceford) vs. fruquintinib

Trifluridine and tipiracil (Lonsurf) are approved for the treatment of metastatic colorectal cancer and certain types of gastric cancer after failure of previous treatments. They work by incorporatingDNA and inhibiting cell proliferation. Fruquintinib is a newer oral drug used to treat metastatic colorectal cancer in patients who have failed at least two chemotherapy treatments. Although they are all anti-cancer drugs, their mechanisms of action and application methods are different.

Trifluridine tipiracil, a combination of trifluridine and tipiracil, is an oral chemotherapy agent approved for the treatment of patients with metastatic colorectal cancer (mCRC) who have previously received fluoropyrimidine, oxaliplatin, and irinotecan-based chemotherapy (an anti-VEGF biological therapy) and RAS wild-type anti-EGFR therapy. Trifluridine prevents the growth and proliferation of cancer cells by inhibiting their DNA synthesis. This precise mechanism of action not only helps inhibit the growth of cancer cells, but also minimizes damage to normal cells. The role of tipiracil is to increase the concentration of trifluridine in the blood by slowing down the decomposition rate of trifluridine, thereby further enhancing the therapeutic effect. The efficacy of trifluridine and tipiracil was demonstrated in the pivotal Phase III trial RECOURSE, which showed a median overall survival benefit. Median overall survival for patients who received treatment was 7.1 months, demonstrating a statistically significant improvement in survival for patients with refractory mCRC.

Fruquintinib is an oral targeted therapy drug that is a vascular endothelial growth factor receptor (VEGFR) inhibitor. It inhibits the growth and spread of tumors by inhibiting the growth and development of tumor blood vessels and preventing tumors from obtaining oxygen and nutrients from the blood. Fruquintinib is mainly used to treat patients with metastatic colorectal cancer who have progressed after at least two chemotherapy regimens have failed. It can be used as a single-agent maintenance treatment. The efficacy of fruquintinib in the treatment of metastatic colorectal cancer was evaluated in the FRESCO trial, a randomized, double-blind, placebo-controlled Phase III study. In this trial, fruquintinib showed significant improvements in overall survival and progression-free survival compared with placebo in patients with mCRC who had failed at least two prior chemotherapy regimens.

When deciding which drug to use, doctors evaluate factors such as the patient's specific condition, the characteristics of the tumor and the patient's overall health. The most important thing for each patient is to have full discussion and consultation with the doctor to develop an appropriate treatment plan based on the individual situation.