Lonsurf® (Trifluridine/Tipiracil) Plus Chemotherapy in Metastatic Colorectal Cancer Prospective Study in Taiwan

Inclusion Criteria:

1. Histologically or cytologically confirmed adenocarcinoma of the metastaticcolorectal cancer;

2. Previously treated with fluorouracil-, oxaliplatin-, and irinotecan-basedchemotherapy, and anti-vascular endothelial growth factor (anti-VEGF) biologicaltherapy;

3. The RAS wild-type patients need to receive anti-EGFR therapy;

4. Presence of at least one measurable tumor lesion which is defined as lesion that canbe measured in at least one dimension (longest diameter) with a minimum size of : 10mm by CT scan, MRI and PET-CT(no less than double the slice thickness and aminimum of 10mm)(according to RECIST guideline version 1.1);

5. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1 or 2;

6. Investigators prescribe Lonsurf® for metastatic colorectal cancer patients who hadprior treatment with Anti-VEGF and Anti-EGFR agent on routine basis. Depending onRAS status, patients with RAS mutant receive Lonsurf® as 3rd line treatment, thosewith RAS wild type receive Lonsurf® as 3rd/4th line treatment;

7. Patients received either oxaliplatin or irinotecan.

Exclusion Criteria:

1. Patients previously received Lonsurf® (Trifluridine／Tipiracil) or regorafenib;

2. With active central nervous system (CNS) metastasis (indicated by clinical symptoms,cerebral edema, steroid requirement, or progressive growth);

3. With clinically significant gastrointestinal hemorrhage;

4. Previous or current systemic malignancy with the exception of curatively treatednon-melanoma skin cancer or cervical carcinoma in situ, unless there has been adisease-free interval of at least 5 years;

5. The patient at high risk from treatment complications including but not limited tosymptomatic congestive heart failure, unstable angina pectoris, or cardiacarrhythmia, uncontrolled diabetes, liver or renal failure and psychiatric illness orsocial situation that would preclude study compliance;

6. Active infection.