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Trifluridine–tipiracil for treating metastatic gastric cancer or gastro-oesophageal junction adenocarcinoma after 2 or more therapies

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2 Information about trifluridine–tipiracil

Marketing authorisation indication

2.1 Trifluridine–tipiracil (Lonsurf, Servier) is indicated as 'monotherapy for the treatment of adult patients with metastatic gastric cancer including adenocarcinoma of the gastroesophageal junction, who have been previously treated with at least 2 prior systemic treatment regimens for advanced disease'.

Dosage in the marketing authorisation

2.2 The dosage is based on the patient's body surface area. The recommended starting dose of trifluridine–tipiracil in adults is 35 mg/m2. It is taken orally, twice daily on days 1 to 5 and days 8 to 12 of each 28‑day cycle, for as long as benefit is observed or until unacceptable toxicity occurs. The dosage must not exceed 80 mg per dose.

Price

2.3 The list price of trifluridine–tipiracil is £500 per pack of 20 tablets containing 15 mg of trifluridine and 6.14 mg of tipiracil, and £666.67 per pack of 20 tablets containing 20 mg of trifluridine and 8.19 mg of tipiracil (excluding VAT; BNF online, accessed December 2019).

The company has an existing commercial arrangement with the NHS. This makes trifluridine–tipiracil available to the NHS with a discount, which would have applied to this indication if the technology had been recommended. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.