Fruquintinib is an oral small‑molecule anti‑angiogenic targeted drug, mainly used for the treatment of advanced colorectal cancer. The use of fruquintinib in special populations must strictly follow the principle of individualization, with regimens adjusted according to the patient’s specific conditions and under full medical supervision.
1. Patients with Hepatic and Renal Impairment
Hepatic impairment
Use with caution in patients with mild to moderate hepatic impairment. Fruquintinib is contraindicated in patients with severe hepatic impairment due to insufficient clinical data.
Renal impairment
No dosage adjustment is required for patients with mild to moderate renal impairment, but close monitoring is necessary. There is no clear recommendation for patients with severe renal impairment or those undergoing dialysis; the risk must be evaluated by a physician.
2. Elderly Patients
No dosage adjustment is needed for patients aged 65 years and older. However, due to declined physiological function, elderly patients may have an increased risk of adverse reactions (e.g., hypertension, proteinuria), requiring intensified monitoring.
3. Pregnant and Lactating Women
Pregnancy
Animal studies have shown embryotoxicity; fruquintinib is contraindicated during pregnancy. Women of childbearing potential must use effective contraception for at least 3 months during treatment and after drug discontinuation.
Lactation
The drug may be excreted into breast milk; fruquintinib is contraindicated during breastfeeding. If treatment is necessary, breastfeeding must be discontinued.
4. Pediatric and Adolescent Patients
The safety and efficacy of fruquintinib in patients under 18 years of age have not been established; use in this population is not recommended.
5. Other Special Populations
Patients at bleeding risk
Use with caution in patients with active bleeding, ulcers, or coagulation disorders, as fruquintinib may increase the risk of bleeding.
Patients with hypertension or cardiovascular diseases
Blood pressure must be closely monitored during treatment, and antihypertensive therapy should be initiated if necessary. Fruquintinib is contraindicated in patients with severe uncontrolled hypertension.
6. Drug Interactions and Monitoring
Concomitant use with strong CYP3A4 inhibitors or inducers may alter plasma drug concentrations, requiring dosage adjustment.
Routine monitoring should include blood pressure, urinalysis (for proteinuria), blood routine (for myelosuppression), and hepatic and renal function.
Note: The above information is for general guidance only. The specific treatment regimen must be comprehensively determined by a physician based on the patient’s condition. Do not adjust the dosage or discontinue the drug without medical advice. Seek immediate medical attention if severe adverse reactions occur (e.g., uncontrolled hypertension, massive bleeding).
