Fruquintinib [FRU1]
Fruquintinib for patients with either metastatic or locally advanced and inoperable colorectal cancer who have received 2 or more prior anticancer treatment regimens including fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies with or without anti-VEGF agents and/or anti- EGFR-based agents AND for whom the combination of trifluridine plus tipiracil and bevacizumab is unsuitable where the following criteria have been met:
- This application is both being made by and the first cycle of systemic anti-cancer therapy with fruquintinib will be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy.
- The patient has a histologically confirmed diagnosis of adenocarcinoma of the colon or rectum.
- The patient has either metastatic disease or locally advanced and inoperable disease.
- The patient has been previously treated for metastatic or locally advanced and inoperable disease with 2 or more prior anticancer regimens including fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies. Note: the regimens of either FOLFIRINOX or FOLFOXIRI can be counted as 2 chemotherapy regimens.
- The patient has been previously treated with anti-EGFR-containing chemotherapy or not. Please tick which option applies to this patient:
- yes, the patient has been previously treated with anti-EGFR-containing chemotherapy or
- no, the patient has not been previously treated with anti-EGFR-containing chemotherapy
- The patient has been previously treated with an anti-VEGF-containing chemotherapy or not. Please tick which option applies to this patient:
- yes, the patient has been previously treated with an anti-VEGF-containing chemotherapy or
- no, the patient has not been previously treated with an anti-VEGF-containing chemotherapy
- The patient has been previously treated with regorafenib or not. Please tick which option applies to this patient:
- yes, the patient has been previously treated with regorafenib or
- no, the patient has not been previously treated with regorafenib
- The patient is unsuitable for treatment with the combination of trifluridine plus tipiracil and bevacizumab for one of the reasons listed below – please tick the appropriate box:
- the patient has already been treated with the combination of trifluridine plus tipiracil and bevacizumab or
- the patient has already been treated with trifluridine plus tipiracil or
- the patient has a contraindication to treatment with trifluridine plus tipiracil or
- the patient has a contraindication to bevacizumab or
- the patient has previously had poor or no responses to cytotoxic therapy and hence further treatment with cytotoxic chemotherapy is considered inappropriate or
- the patient has previously tolerated cytotoxic chemotherapy poorly and hence further treatment with cytotoxic chemotherapy is inappropriate
- The patient has not been previously treated with fruquintinib unless transferring from a company early access scheme and all other treatment criteria on this form are fulfilled.
- The patient has an ECOG performance status of 0 or 1.
- The prescribing clinician understands that concomitant use of fruquintinib with strong or moderate CYP3A inducers should be avoided (see section 4.5 of the fruquintinib SPC).
- The prescribing clinician is aware of the SPC 4.4 recommendation that in the view of the risk of arterial thromboembolic events, starting treatment with fruquintinib is avoided in patients with a history of thromboembolic events (including a DVT or PE) within the past 6 months or if they have a history of stroke and/or TIA within the last 12 months.
- Fruquintinib is to be used as monotherapy.
- Fruquintinib is to be continued until loss of clinical benefit or unacceptable toxicity or patient choice to stop treatment, whichever is the sooner.
- A formal medical review as to whether treatment with fruquintinib should continue or not will be scheduled to occur no later than by the end of the 2nd (28-day) cycle of therapy.
- When a treatment break of more than 6 weeks beyond the expected 4-weekly cycle length is needed, I will complete a treatment break approval form to restart treatment.
- Fruquintinib will be otherwise used as set out in its Summary of Product Characteristics (SPC).
CDF funded From: 03 July 2025
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