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Systemic Anti-Cancer Therapy Regimen Library

CRC Metastatic - trifluridine/tipiracil and beVACizumab

Treatment Overview

This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.

Cycle 1 (and all further cycles) - 28 days

Cycle length:
28

Cycle details

Cycle 1 (and all further cycles) - 28 days

Medication Dose Route Days Max Duration
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration 1 to 5,
8 to 12
beVACizumab 5 mg/kg intravenous 1, 15 90 minutes
loperamide 2 mg oral administration 1

Full details

Cycle 1 (and all further cycles) - 28 days

Day: 1

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.
beVACizumab 5 mg/kg intravenous 90 minutes
Instructions:
  • Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion.
  • If the initial dose of beVACizumab is well tolerated, the second dose may be administered over 60 minutes, and the third and subsequent doses may be administered over 30 minutes.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 3

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 4

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 5

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 8

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 9

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 10

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 11

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 12

Medication Dose Route Max duration Details
trifluridine + tipiracil 35 mg/m² Twice daily Cap dose per administration at: 80 mg oral administration
Instructions:
  • Dose expressed is based on trifluridine component.
  • Take with or just after food, or a meal. Swallow whole, do not crush or chew.

Day: 15

Medication Dose Route Max duration Details
beVACizumab 5 mg/kg intravenous 90 minutes
Instructions:
  • Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion.
  • If the initial dose of beVACizumab is well tolerated, the second dose may be administered over 60 minutes, and the third and subsequent doses may be administered over 30 minutes.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Variable
Hypersensitivity / Infusion related reaction risk: Low - routine premedication not recommended

Emetogenicity:

  • MINIMAL to LOW days 1 to 5 and 8 to 12: Antiemetics may be required with continuous dosing of oral anti-cancer medicines with MINIMAL to LOW emetic risk; an individualised approach is appropriate.
  • MINIMAL day 15.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.