LONSURF® (trifl uridine and tipiracil) tablets are a prescription medicine used to treat people with colon or rectal cancer that has spread to other parts of the body and who have been previously treated with or cannot receive certain chemotherapy medicines. It is not known if LONSURF is safe and effective in children. In a clinical trial, half of the patients treated with LONSURF were still alive at 7.1 months and half of the patients who received placebo were still alive at 5.3 months. Worsening of the disease or death occurred in 88% of patients treated with LONSURF and 94% of patients who received placebo. Selected Important Safety Information Low blood counts. LONSURF can decrease the number of your blood cells. This can sometimes be severe and life-threatening. Please see Important Safety Information on pages 18 and 19 and full Prescribing Information in pocket. Table of contents 4 About this booklet Support, tools, and resources 5 About colon or rectal cancer 34 Taiho Oncology Patient Support 35 LONSURF Starter Kit About LONSURF® (trifl uridine and tipiracil) tablets 36 Online resources 8 What is it? 37 Advocacy groups 9 Who is it for? 10 How it works Living with and managing colon or rectal cancer 11 What to expect 40 Coping with advanced colon or rectal cancer 14 How to take it 42 Tips for your appointments 44 Tips for your caregivers Safety 18 Important Safety Information Appendix 20 Managing side effects 48 Glossary 31 Potential treatment changes 54 Journal 60 Important contact information Please see Important Safety Information on pages 18 and 19 and full Prescribing Information in pocket. 2 3 About About this booklet colon or rectal cancer You have been through a lot since your colon or rectal cancer diagnosis. Fast facts You have had a number of treatments, experienced certain side effects, and dealt with a whole range of emotions. Hearing the news that a treatment You have likely read a lot about colon or rectal cancer since you has stopped working is never easy—but LONSURF® (trifl uridine and tipiracil) tablets offer you another treatment option. were diagnosed. LONSURF is for those As you may have already discovered, colon and rectal cancers combined are the third most common • Whose colon or rectal cancer has spread to other parts cancers in men and women. of the body Approximately 1 in 20 Americans will be diagnosed • Who have been previously treated with or cannot receive with colon or rectal cancer in his or her lifetime. certain chemotherapy medicines • Who now may need another option In 2017, about 71,400 men and 64,000 women in the United States were projected to be diagnosed with colon or rectal cancer. It may give you the chance to journey longer alongside your family, friends, and loved ones. LONSURF was studied in a clinical trial of 800 patients. What is refractory metastatic colon or rectal cancer (mCRC)? • Half of the patients treated with LONSURF were still alive at 7.1 months and half of the patients who received placebo were still alive at 5.3 months Refractory means that the cancer has continued to grow despite treatment. The cancer may be resistant in the beginning of treatment or it may become • Worsening of the disease or death occurred in 88% of patients treated with resistant during treatment. LONSURF and 94% of patients who received placebo Metastatic means that the cancer has spread to other parts of the body. This booklet can help you and your caregiver(s) make the most of your new treatment plan with LONSURF. In the following pages, you will fi nd information about helpful resources and places to go for treatment, fi nancial, and emotional support services. Note that bold purple words are defi ned in the glossary, which begins on page 48. The glossary also includes other terms that you may hear while on treatment. The information in this booklet is not a substitute for your healthcare provider’s advice. Always ask your healthcare provider any questions you may have about LONSURF and colon or rectal cancer. Please see Important Safety Information on pages 18 and 19 and full Prescribing Information in pocket. 4 5 About LONSURF About colon or rectal cancer (continued) You can learn more about colon or rectal cancer through these organizations • Cancer Care®: Go to cancercare.org or call 1-800-813-HOPE (4673) • Fight Colorectal Cancer: Go to fi ghtcolorectalcancer.org or call 1-877-427-2111 • Cancer Support Community (CSC): Go to cancersupportcommunity.org or call 1-888-793-9355 • Colon Cancer Alliance: Go to ccalliance.org or call 1-877-422-2030 Trademarks, registered or otherwise, are the property of their respective owners. For more information about these organizations, please see pages 37 and 38 of this booklet. Please see Important Safety Information on pages 18 and 19 and full Prescribing Information in pocket. 6 7 About LONSURF What is it? Who is it for? LONSURF® (trifl uridine and tipiracil) tablets are a prescription medicine for LONSURF is used to treat those with colon or rectal cancer that has spread to refractory mCRC. other parts of the body and who have been previously treated with or cannot take certain chemotherapy medicines. LONSURF is an oral tablet, which means it is taken by mouth. It is a prescription chemotherapy tablet that is made up of 2 parts. Those previous medicines may include (These parts are explained on page 10.) • Fluoropyrimidine : Such as 5-fl uorouracil, also known as 5-FU LONSURF offers you a chance to continue treating your cancer. It may • Oxaliplatin-based treatment: Such as FOLFOX (5-FU, leucovorin, help you live longer and slow or stop the growth of your cancer for a and oxaliplatin); CAPOX (capecitabine and oxaliplatin); or period of time. Eloxatin® (oxaliplatin) LONSURF was studied in a clinical trial of 800 patients. • Irinotecan-based treatment: Such as FOLFIRI (5-FU, leucovorin, • Half of the patients treated with LONSURF were still alive at 7.1 months and irinotecan); CAPIRI (capecitabine and irinotecan); or and half of the patients who received placebo were still alive at 5.3 months Camptosar® (irinotecan) • Worsening of the disease or death occurred in 88% of patients treated with LONSURF and 94% of patients who received placebo • Anti- VEGF biological therapy, or VEGF inhibitors: Such as Avastin® (bevacizumab) or Zaltrap® (ziv-afl ibercept) LONSURF comes in 2 strengths: 15-mg and 20-mg tablets.* Your healthcare provider may prescribe both strengths for your • Anti- EGFR therapy, or EGFR inhibitors (if you have the KRAS wild ® ® prescribed dose. type gene): Such as Erbitux (cetuximab); or Vectibix (panitumumab) If you aren’t sure what treatments you’ve had in the past, ask your healthcare provider. Registered trademarks are the property of their respective owners. *Tablet strength of LONSURF is based on 1 active part of the medicine. Please see Important Safety Information on pages 18 and 19 and full Prescribing Information in pocket. 8 9 How it works What to expect LONSURF® (trifl uridine and tipiracil) tablets work in a different way than other How can LONSURF help me? treatments for colon or rectal cancer. That is why it may still help people for whom other treatments have stopped working. LONSURF has been proven to LONSURF is the fi rst FDA-approved combination tablet for refractory mCRC. • Allow some patients with refractory mCRC to live longer It is an oral chemotherapy that is 2 medicines in 1. With the 2 medicines working together, LONSURF may help stop cancer cell growth (see • Slow or stop the growth of cancer for a period of time diagram below). Like all medicines approved by the FDA, LONSURF was studied in • One part (A) helps the other part (B) stay active and work properly clinical trials. The clinical trial in which LONSURF was studied – Without A, B would break down included 800 patients. • The second part (B) stops cells from making copies of themselves. • Half of the patients treated with LONSURF were still alive at 7.1 months This may help stop tumors from growing and half of the patients who received placebo were still alive at 5.3 months • Worsening of the disease or death occurred in 88% of patients treated with LONSURF and 94% of patients who received placebo B alone A + B Some people in the trial lived longer than others. It is diffi cult to say exactly how much LONSURF may help extend a particular person’s life, because everyone is different. B breaks down A prevents breakdown of B B inhibits cancer cell growth FDA=Food and Drug Administration. Please see Important Safety Information on pages 18 and 19 and full Prescribing Information in pocket. 10 11 What to expect (continued) What is the most important information I should know What are the most common side effects caused by LONSURF? about LONSURF? Almost all patients treated with LONSURF experience side effects at some time. Your healthcare provider should check your blood cell counts before Some common side effects you may experience include you receive LONSURF® (trifl uridine and tipiracil) tablets, at day 15 • Tiredness of each treatment cycle, and as needed. • Nausea • Low blood counts are common with LONSURF and can sometimes be severe and life-threatening. LONSURF can cause a decrease in your • Vomiting white blood cells, red blood cells, and platelets. Low white blood cells can make you more likely to get serious infections that could lead to death. • Decreased appetite Your healthcare provider may lower your dose or stop LONSURF if you have • Diarrhea low white blood cell or low platelet counts • Abdominal pain • Tell your healthcare provider right away if you develop any signs of infection such as fever, chills, or body aches • Fever Tell your healthcare provider if you have nausea, vomiting, or diarrhea that is severe or that does not go away.