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TAS-102 Shows Similar Efficacy to 5-FU in Gastric/GEJ and Colorectal Cancers

Howard S. Hochster, MD
Published Online:12:48 PM, Thu August 15, 2019

Howard S. Hochester, MD, associate director for clinical research at Rutgers Cancer Institute of New Jersey, discusses the role of TAS-102 (trifluridine/tipiracil; Lonsurf) in patients with gastric/gastroesophageal junction (GEJ) or colorectal cancer (CRC) in comparison to fluorouracil (5-FU).

Hochester says there is rationale for bringing TAS-102 into earlier lines of treatment in both gastric/GEJ cancers and CRC. A pooled analysis, presented at the 2019 ASCO Annual Meeting, investigated the efficacy of this agent from 3 phase III trials. TAS-102 demonstrated similar rates of efficacy and toxicity in patients with CRC and gastric/GEJ cancer.

Use of 5-FU could be replaced by TAS-102 in earlier regimens to prolong survival, according to Hochester. The nucleoside analog trifluridine was synthesized in 1962 by Charles Heidelberger, PhD, who also made 5-FU. However, trifluridine had a very short half-life and was not clinically useful until it was combined with an inhibitor of metabolism of that nucleoside.

TAS-102 is an oral pill that can be given to patients twice daily. It is active when 5-FU no longer works or when the cells become resistant to 5-FU, Hochester says. In patients with CRC specifically, TAS-102 has demonstrated activity in heavily pretreated patients who have previously received 5-FU.
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