Fruquintinib
A Chinese-discovered pill that blocks the blood-vessel receptors, approved in 2023 for bowel cancer after all standard treatments.
Highly selective VEGFR1/2/3 inhibitor. FRESCO (China, 2018) and FRESCO-2 (global, 2023) showed OS benefit (7.4 vs 4.8 months in FRESCO-2). FDA approval November 2023; EU 2024. Better tolerated than regorafenib; hypertension, hand-foot syndrome, proteinuria.
1.Fruquintinib enters blood-vessel cells and binds VEGFR kinases
- Route
- Oral
- Schedule
- 5 mg once daily, days 1-21 of a 28-day cycle
- Dose modifications
- Reduce to 4 mg then 3 mg for toxicity
- Monitoring
- Blood pressure, urine protein, liver tests, thyroid
Source: www.accessdata.fda.gov/drugsatfda_docs/label/2023/217564s000lbl.pdf. Doses are for orientation; the current label governs.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
- Commercial insurance
- covered with prior authorisation
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy. Prior fluoropyrimidine, oxaliplatin, irinotecan and anti-VEGF therapy documented.
- Assistance programmes
- Takeda Oncology Here2Assist
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Notes
- Licensed 2024 for previously treated metastatic colorectal cancer; NICE recommended it in 2024. TA number not verified.
Sources: NICE search: fruquintinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
- 8 Nov 2023ApprovalUS
FRESCO-2
Approvals
| Region | Year | Indication |
|---|---|---|
| China | 2018 | Refractory mCRC (FRESCO) |
| US | 2023 | Refractory mCRC after fluoropyrimidine, oxaliplatin, irinotecan, anti-VEGF, and anti-EGFR if appropriate |
| Adverse event |
|---|
| Hypertension |
| Hand-foot syndrome |
| Proteinuria |
| Hypothyroidism |
Most common grade 3 event. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Latest papers
topQuery for this drug: (TITLE:"Fruquintinib" OR ABSTRACT:"Fruquintinib" OR TITLE:"Fruzaqla" OR ABSTRACT:"Fruzaqla") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Fruquintinib, not a curated reading list.