Biweekly Dosing of Trifluridine-tipiracil Reduces Rates of Myelosuppression in Metastatic Colorectal Cancer Patients

Strategic Insights -

Research from the Fox Chase Cancer Center has shown that biweekly dosing of trifluridine-tipiracil (TAS-102) can reduce the rates of myelosuppression in patients with metastatic colorectal cancer while maintaining efficacy. This alternative dosing schedule may potentially broaden the utilization of TAS-102 in patients with borderline performance status and provide a favorable option for future combination studies.

Key Takeaways:

  • The recommended dose of TAS-102 is 35 mg/m2 twice daily on days 1-5 and days 8-12 of 28-day cycles, commonly resulting in grade 3-4 neutropenia, dose delays/reductions, and requiring GCSF support.
  • A retrospective analysis of 61 patients with metastatic colorectal cancer who received biweekly dosing of TAS-102 demonstrated a reduction in grade 3-4 neutropenia (16.3%) and anemia (8.2%) relative to the historic controls of the RECOURSE and SUNLIGHT trials.
  • Biweekly dosing of TAS-102 resulted in a median progression-free survival (PFS) of 4.2 months and a median overall survival (OS) of 9.2 months in patients with metastatic colorectal cancer.
  • The biweekly dosing schedule of TAS-102 reduced the rates of myelosuppression, with similar PFS and OS, making it a potential alternative dosing schedule.
  • The research concluded that biweekly dosing of TAS-102 demonstrated a reduction in myelosuppression, with similar PFS and OS, and may potentially broaden the utilization of TAS-102 in patients with borderline performance status.

Statistics:

  • 56:5 mCRC:appendiceal CA ratio among patients included in the study
  • Median ECOG performance status (PS) = 1
  • Median number of prior therapies = 3
  • Reduction in grade 3 neutropenia (16.3%) and grade 3 anemia (8.2%) relative to the historic controls of the RECOURSE and SUNLIGHT trials
  • Median progression-free survival (PFS) of 4.2 months
  • Median overall survival (OS) of 9.2 months
  • Number of patients requiring a dose delay: 8

Sources:

  • Fox Chase Cancer Center
  • University of Wisconsin Carbone Cancer Center
  • The Oncologist, 2025;30(5)
  • NewsRx. Researchers from Fox Chase Cancer Center Discuss Findings in Colon Cancer (Biweekly Dosing of Trifluridine-tipiracil Reduces Rates of Myelosuppression While Maintaining Efficacy In Patients With Metastatic Colorectal Cancer). Immunotherapy Weekly. June 25, 2025; p 2903.