How long can the best effect of trifluridine and tipiracil (Lanceford) be controlled?

Trifluridine and tipiracil (Lonsurf) are an oral combination of the antineoplastic nucleoside analog trifluridine (FTD) and the thymidine phosphorylation inhibitor tipiracil (TPI). Tipiracil has both an enhanced effect on trifluridine and a separate anti-angiogenic effect. However, the duration of the optimal control effect of trifluridine and tipiracil varies with individual differences and disease characteristics.

A Japanese phase II study and subsequent phase III trials in 2014 and 2015 respectively demonstrated the safety and efficacy of trifluridine and tipiracil. Trifluridine and tipiracil showed efficacy relative to placebo in the RECOURSE trial, improving overall survival from 5.3 months to 7.1 months with a hazard ratio of 0.68 and improving progression-free survival (PFS) with a hazard ratio of 0.48. The response rate was just 1.6%, but the disease control rate (including stable disease) was 44% compared with 16% in the placebo group. The most common adverse event was neutropenia, with one treatment-related death. Although trifluridine and tipiracil provided smaller PFS and OS benefits overall, a group of patients who experienced long-term disease control were identified, all of whom had left-sided disease and the majority were RAS wild-type. In addition, many patients received further systemic therapy after discontinuation of trifluridine and tipiracil with good results.

Studies show that trifluridine-tipiracil treatment is usually effective for a few months to about a year. However, this is only a rough reference value and may not apply to all patients. Different people may respond differently to this drug, and the rate at which the disease progresses may vary from person to person.