Trifluridine-tipiracil (TAS-102), as a novel fluorouracil-based chemotherapeutic agent, effectively overcomes fluorouracil resistance in colorectal cancer (CRC) through its unique pharmacological mechanisms, providing a critical treatment option for advanced CRC patients. Probiotics have shown unique value in CRC prevention and adjuvant therapy by regulating intestinal flora homeostasis and modulating host immune response. It is worth noting that the combination of chemotherapeutic drugs and probiotics not only enhances the anti-tumor activity through synergistic effects, but also reduces the adverse effects caused by chemotherapeutic drugs. Based on this, this paper systematically reviews the pharmacological properties of TAS-102 and describes its synergistic effects in combination with other antitumor drugs. It also summarizes the synergistic effect of fluorouracil drugs combined with probiotics to enhance the effectiveness and reduce the toxicity, and discusses the potential value of the combination of TAS-102 and probiotics, which provides a new research direction for optimizing the precision treatment of CRC and a scientific basis for improving the quality of life of patients.

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