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LONSURF is an oral chemotherapy which contains two medicines in the same tablet:

• Trifluridine: May help prevent tumor growth by interfering with the tumor’s DNA
• Tipiracil: Helps trifluridine work longer

Yes, it is a prescription chemotherapy tablet, taken orally.

LONSURF includes two medicines in the same tablet:

• Trifluridine: May help prevent tumor growth by interfering with the tumor’s DNA
• Tipiracil: Helps trifluridine work longer

If you have advanced colon or rectal cancer, LONSURF may be used together with bevacizumab (also referred to by the brand name Avastin^®), which may help slow or stop blood supply to the tumor. The use of LONSURF and bevacizumab together was approved in August 2023 based on the SUNLIGHT trial. In the trial, LONSURF with bevacizumab showed significant improvements in Overall Survival (10.8 vs. 7.5 months) and Progression-Free Survival (5.6 vs. 2.4 months).

The most common side effects of LONSURF when used alone include:

• Low blood counts, tiredness and weakness, nausea, decreased appetite, diarrhea, vomiting, stomach-area (abdominal) pain, and fever

The most common side effects of LONSURF when used in combination with bevacizumab include:

• Low blood counts, tiredness and weakness, nausea, certain abnormal liver function blood tests, decreased salt (sodium) in your blood, diarrhea, stomach-area (abdominal) pain, and decreased appetite

These are not all of the possible side effects of LONSURF. For more information, ask your healthcare provider. Call your healthcare provider for medical advice about side effects.

Please see full Prescribing Information.

LONSURF is taken twice a day with food - the type of food does not matter. Do not retake doses of LONSURF that are vomited or missed and continue with the next scheduled dose.

LONSURF comes in 2 strengths: 15mg and 20mg tablets.* Your healthcare provider may prescribe both strengths for your prescribed dose.

LONSURF dosing schedule:

• You will take LONSURF twice a day (with morning and evening meals) for 5 days, and then rest for the next 2 days. This goes on for 2 weeks. Then you will not take LONSURF for 2 weeks (14 days). This completes the 28-day LONSURF treatment cycle.
• This is repeated for as long as your healthcare provider says. Always follow all of your healthcare provider’s directions carefully.

Create a personalized treatment calendar at LONSURF.com/mycalendar to help you schedule and keep track of your treatment. Your healthcare provider may give you a treatment calendar as well.

For most patients with colorectal cancer, LONSURF may be prescribed to be used with bevacizumab. Bevacizumab is given as an infusion once every 2 weeks (on Days 1 and 15 of your LONSURF treatment cycle) by a doctor or nurse.

Do not retake doses of LONSURF that are vomited or missed and continue with the next scheduled dose. Tell your healthcare provider if you have nausea or vomiting that gets worse or does not go away.

Store LONSURF at room temperature between 68°F to 77°F (20°C to 25°C). Do not store LONSURF with other medicines. Keep LONSURF in its own container. If you store your tablets outside of the original container, any unused LONSURF tablets should be disposed of after 30 days.

Wash your hands after handling LONSURF. Even though it is a pill, it is still chemotherapy. Make sure your caregiver wears gloves when handling LONSURF. Note that there is a packet inside the bottle that helps absorb moisture. Do not swallow this material. Keep LONSURF out of the reach of children.

To get answers to your questions about LONSURF, contact us at 1‑844‑TAIHO‑4U (1‑844‑824‑4648).

Yes. Taiho Oncology Patient Support is here to help you obtain access to your Taiho Oncology Medicine. Our program offers a benefits review to confirm coverage, co-pay assistance enrollment for eligible patients to receive a LONSURF copay card which may reduce co-pay responsibility to $0, specialty pharmacy prescription coordination, and personalized nurse support for patients taking LONSURF.

For more information about LONSURF financial support, call 1‑844‑TAIHO‑4U (1‑844‑824‑4648) or go to TaihoPatientSupport.com.

Your doctor may change your LONSURF treatment plan for various reasons including:

• adjusting your dosage due to side effects you may be experiencing such as a decrease in white blood cells, red blood cells, or platelets, or if you experience other serious side effects.
• adding bevacizumab (also known as Avastin) to be used in combination with LONSURF which the SUNLIGHT clinical trial showed meaningfully improvements in treatment outcomes.

Talk to your healthcare provider about any changes to your treatment plan.

There are 3 ways your doctor may change your treatment plan. It is not uncommon to receive a change in your treatment plan. In each case, your doctor may first delay your treatment. Delaying your treatment is an important step your doctor may take before deciding whether to:

1. Resume your LONSURF treatment at the same dose
2. Resume your LONSURF treatment at a lower dose
3. Stop your LONSURF treatment permanently

Low white blood cell counts can make you more likely to get serious infections. Serious infections could be fatal. Your doctor may change your treatment to prevent blood cell counts from lowering to a dangerous level.

Tell your doctor right away if you develop any signs of infection such as fever, chills, or body aches. You can use the thermometer in the Treatment Kit to check your temperature each day.

Every patient can react differently to therapy. However, when LONSURF was used as a single agent, 7% of patients experienced some sort of alopecia (also known as hair loss) compared to 1% of patients receiving placebo.

Colon and rectal cancer are often referred to as colorectal cancer. It includes cancer that starts in the colon or rectum, which are both parts of the lower digestive system. Metastatic means that the cancer has spread to other parts of the body. Together, colon and rectal cancer are the fourth most common in the United States among men and women.

Stomach cancer is often referred to as gastric cancer. It includes cancer that starts to grow in the lining of the stomach. A similar type of cancer is gastroesophageal junction cancer (also known as GE Junction or GEJ). This is cancer that starts to grow in the place where the esophagus and the stomach meet. Metastatic means that the cancer has spread to other parts of the body. While it is less common in the United States, stomach cancer is the fifth most common cancer in the world.