TL;DR - Quick Takeaways
- **Trecator SC** is the sub‑cutaneous form of the anti‑cancer drug trifluridine/tipiracil.
- It’s prescribed mainly for metastatic colorectal cancer after other treatments fail.
- Standard dosing is 35mg/m² on days1-5 and8-12 of a 28‑day cycle, given as a sub‑cut injection.
- Common side effects: nausea, fatigue, neutropenia, and hand‑foot syndrome.
- Never use if you’re pregnant, have severe liver disease, or are allergic to any component.
What Is Trecator SC?
Trecator SC is the brand name for a sub‑cutaneous formulation of the chemotherapy combo trifluridine/tipiracil. While the oral tablets are more widely known, the SC version was developed to give patients who can’t swallow pills-or who need a steadier plasma level-a reliable alternative.
The drug works by disrupting DNA synthesis in rapidly dividing cancer cells. It’s not a cure, but clinical trials show it can extend survival and improve quality of life for people with advanced colorectal cancer that’s resistant to first‑line therapies.
How Trecator SC Works - Mechanism of Action in Plain English
Think of cancer cells as factories that keep cranking out new DNA. Trifluridine is a nucleoside analogue; it pretends to be one of the building blocks of DNA. When the cell incorporates it, the DNA strand becomes faulty and the cell can’t divide properly.
Tipiracil’s job is to protect trifluridine from being broken down too quickly in the gut and bloodstream, letting more of it reach the tumor. When injected sub‑cutaneously, the drug bypasses the digestive system altogether, giving a more controlled exposure.
Dosage, Administration, and Practical Tips
Getting the dose right is crucial. Below is the standard regimen used in most oncology clinics, but always follow your doctor’s exact instructions.
- Calculate body surface area (BSA). Most oncologists use the DuBois formula: BSA (m²) = 0.007184 × weight^0.425 × height^0.725.
- Multiply 35mg by your BSA to get the total dose per injection day.
- Administer the injection on days1‑5 and8‑12 of a 28‑day cycle. There’s a 2‑day break after each 5‑day block.
- Use a sterile, pre‑filled syringe provided by the pharmacy. Rotate injection sites (abdomen, thigh, or upper arm) to reduce skin irritation.
- Observe the patient for at least 30minutes after the first dose for any acute reactions.
Key practical pointers:
- Store the vial in a refrigerator (2‑8°C) and let it reach room temperature before injection.
- If you miss a dose, skip it and continue with the next scheduled day-don’t double up.
- Keep a treatment diary: note the date, dose, site, and any side effects.
Benefits, Risks, and How to Manage Side Effects
While Trecator SC isn’t a miracle cure, it can add months-sometimes years-to a patient’s life when other options have run out.
| Benefit | Typical Impact |
|---|---|
| Extended overall survival | Median increase of 2-3months in clinical trials |
| Improved disease control | Slower tumor growth, delayed progression |
However, the drug carries a well‑documented side‑effect profile. Below is a quick guide to the most common issues and how to tackle them.
| Side Effect | Incidence | Management Tips |
|---|---|---|
| Nausea & vomiting | ≈40% | Take anti‑emetics 30min before injection; eat small, bland meals. |
| Neutropenia (low white cells) | ≈35% | Regular blood counts; consider growth‑factor support if severe. |
| Hand‑foot syndrome | ≈20% | Moisturize skin, avoid heat, report early signs to oncologist. |
| Fatigue | ≈30% | Balance activity with rest; stay hydrated; address anemia if present. |
Never ignore severe reactions like fever, persistent diarrhea, or allergic symptoms (rash, swelling, breathing difficulty). Call your healthcare team immediately.
Frequently Asked Questions (Mini‑FAQ)
- Is Trecator SC covered by Medicare or private insurance? Most Australian health funds list it under “cancer chemotherapy - injectable”. Check your specific plan for co‑pay details.
- Can I take Trecator SC if I’m pregnant? No. The drug is teratogenic and classified as Pregnancy CategoryD. Effective contraception is mandatory.
- Do I need any pre‑medication? Anti‑emetics are standard; some clinics also give a mild antihistamine to reduce injection site reactions.
- How long does each treatment cycle last? A full cycle is 28days, but patients may receive multiple cycles until disease progression or intolerable toxicity.
- Is there a generic version? As of 2025, no approved generic for the SC formulation exists in Australia.
Next Steps - What To Do After Reading This
If you or a loved one has been prescribed Trecator SC, the best move is to sit down with the oncology team and review these points. Bring a printed copy of this guide, note any questions, and ask for a written dosing schedule.
For anyone still weighing options, compare Trecator SC with the oral tablets or other late‑line agents like regorafenib. Your doctor can run a simple decision‑tree based on performance status, liver function, and personal preferences.
Finally, keep an eye on upcoming clinical data. Trials combining Trecator SC with immunotherapy are underway, and results could shift the standard of care before the end of 2026.
