The National Institute for Health and Care Excellence has recommended trifluridine/tipiracil as an option for treating metastatic colorectal cancer.

The medicine, marketed by Servier as Lonsurf, is recommended in adults who have received other available therapies, including fluoropyrimidine, oxaliplatin or irinotecan chemotherapy, anti-vascular endothelial growth factor (VEGF) agents and anti-epidermal growth factor receptor (EGFR) agents, or where such therapies are not suitable.

Lonsurf, previously known as TAS-102, is a combination of two drugs; trifluridine is a nucleoside analogue anti-viral drug previously used to treat eye infections, while enzyme-inhibitor tipiracil increases the bioavailability of trifluridine preventing its breakdown.

In its draft final guidance, the Institute noted that the medicine had an ICER (incremental cost-effectiveness ratio) of £49,392 per QALY and stated it was only recommending it as part of a patient access scheme including a confidential price discount.

The average cost per patient per cycle of treatment is £1,625 based on the discounted price.

As part of the guidance, NICE recognised that Lonsurf met both its short life expectancy and end-of-life criteria, concluding that it extended survival in critically ill patients.

"Potentially adding an average of 3.2 months to a particularly short life expectancy of 7.9 months would represent a clinically meaningful benefit," read the guidance. "The committee appreciated that trifluridine-tipiracil hydrochloride represents a well-tolerated treatment that would help extend life by even a relatively short time, while maintaining a reasonably good quality of life at a late stage in the treatment pathway when there are no further options left."

Commenting in February, when Lonsurf received a positive opinion from CHMP, Dr Patrick Therasse, head of development, oncology at Servier, described it as "an important step forward in the treatment of patients with metastatic colorectal cancer." He added: "Patients with metastatic colorectal cancer who do not respond to standard therapies currently have limited therapeutic options. The availability of an oral treatment that could help to extend overall survival will be an important advantage for patients."