For patients with KRAS-mutant metastatic colorectal cancer whose disease progresses after two lines of treatment, third-line therapies can extend survival, but the benefits are often measured in months. As a result, doctors must carefully weigh treatment effectiveness, side effects, and quality of life when selecting therapy.
Two commonly used options are trifluridine/tipiracil (Lonsurf) plus bevacizumab and fruquintinib (Fruzaqla). Clinical trials showed both treatments improved overall survival compared with their control groups. Lonsurf plus bevacizumab increased median survival to 10.8 months, while fruquintinib increased it to 9.3 months.
The choice often depends on a patient’s health status. Lonsurf plus bevacizumab carries a higher risk of low blood counts and may require dose adjustments or supportive care. Fruquintinib has little impact on blood counts but is more likely to cause high blood pressure and hand-foot skin reactions. It also offers the convenience of an all-oral treatment without intravenous infusions.
Both therapies helped patients maintain physical function for longer, highlighting the importance of preserving quality of life in advanced cancer care.