Comparative Pharmacology
Head-to-head clinical analysis: LONSURF versus XTANDI.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LONSURF versus XTANDI.
LONSURF vs XTANDI
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
LONSURF (trifluridine and tipiracil) is a combination of the thymidine-based nucleoside analogue trifluridine and the thymidine phosphorylase inhibitor tipiracil. Trifluridine incorporates into DNA and inhibits cell proliferation, while tipiracil increases trifluridine exposure by inhibiting its degradation by thymidine phosphorylase.
Androgen receptor inhibitor; binds to the androgen receptor, inhibits nuclear translocation, DNA binding, and transcription of androgen-responsive genes.
Adults: 35 mg/m2 orally twice daily on days 1-5 and 8-12 of each 28-day cycle.
160 mg orally once daily.
None Documented
None Documented
Trifluridine: terminal half-life approximately 1.4-2.1 hours; tipiracil: terminal half-life approximately 2-3 hours. Clinical context: short half-lives necessitate twice-daily dosing on Days 1-5 and 8-12 of a 28-day cycle.
Enzalutamide: 5.8 days; active metabolite N-desmethyl enzalutamide: 7.8-8.6 days. Steady state achieved after ~28 days.
Primarily renal: tipiracil is excreted unchanged in urine (approximately 50% of dose); trifluridine is eliminated via metabolism and renal excretion (as metabolites and unchanged drug). Fecal elimination accounts for <3% of total clearance.
Primarily hepatic metabolism; 77% of dose recovered in feces (as metabolites), 15% in urine (as metabolites); less than 1% excreted unchanged.
Category C
Category C
Antineoplastic
Antineoplastic