Cremolini C, et al. - Researchers investigated the cost-benefit ratio of TAS-102 in metastatic colorectal cancer (mCRC), using the “ColonLife” nomogram that allows an estimate of the 12-week life expectancy of patients with refractory mCRC and using data from patients treated at eight Italian centers in the compassionate use program. Among patients who received both TAS-102 and regorafenib, clinical outcomes of the two sequences were compared. They found that TAS-102 offered clinical benefit in one out of five patients. These patients may be detected taking into account Eastern Cooperative Oncology Group performance status (ECOG PS), lactate dehydrogenase (LDH), and time from diagnosis of metastatic disease. Excluding patients with very short life expectancy appeared a reasonable approach. Overall, there is a need to improve the cost-efficacy ratio of TAS-102 in mCRC in order to spare useless toxicities in a definitely palliative setting.