Drug Interaction Report

CONTRAINDICATED: Talimogene laherparepvec is a live, attenuated herpes simplex virus. Administration during immunosuppressant or intense antineoplastic therapy may be associated with a risk of potentially life-threatening disseminated herpetic infection due to enhanced virus replication in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents, or long-term topical or inhaled corticosteroids.

MANAGEMENT: Talimogene laherparepvec should not be used in patients receiving immunosuppressive therapy or cancer chemotherapy. Treatment with talimogene laherparepvec may need to be deferred until after such therapy is discontinued and the patient's immune system has sufficiently recovered.

ADJUST DOSING INTERVAL: Administration of trifluridine-tipiracil with a standardized high-fat, high-calorie meal has been shown to decrease trifluridine peak plasma concentration (Cmax) as well as tipiracil Cmax and systemic exposure (AUC) by approximately 40% compared to administration in a fasting state in patients with cancer given a single 35 mg/m2 dose. No change in trifluridine AUC was observed.

MANAGEMENT: Based on the observed correlation between increases in the Cmax of trifluridine and decreases in neutrophil counts, trifluridine-tipiracil should be taken within one hour after completion of the morning and evening meals.