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Fruquintinib is a highly selective oral small-molecule tyrosine kinase inhibitor that targets vascular endothelial growth factor receptors (VEGFR)-1, -2, and -3. By inhibiting these receptors, fruquintinib blocks the VEGF signaling pathway essential for tumor angiogenesis—the process by which tumors develop new blood vessels to support their growth. This mechanism results in the inhibition of endothelial cell proliferation and tubule formation, thereby slowing or stopping tumor progression. Fruquintinib is primarily indicated for adults with metastatic colorectal cancer who have previously received standard chemotherapy regimens (fluoropyrimidine-, oxaliplatin-, irinotecan-based therapies), anti-VEGF therapy, and if appropriate based on RAS status, anti-EGFR therapy. The drug was developed independently in China as a next-generation VEGFR inhibitor with improved selectivity and reduced off-target toxicity compared to earlier agents.
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