What is metastatic colorectal cancer (mCRC)?

mCRC is a stage of colorectal cancer during which the cancer has spread from the colon or rectum to other parts of the body (metastasis). It is also known as stage 4 cancer or advanced colorectal cancer. Approximately 23% of people diagnosed with CRC are diagnosed after their cancer has already metastasized

The most common areas it spreads to are the liver, lungs, brain, distant lymph nodes, and peritoneum (membrane that lines the abdominal cavity).

What are the common symptoms of mCRC?

Shortness of breath or fatigue, which may be caused by the cancer, its treatment, or other lung conditions
Bowel blockage, which may cause severe cramping, belly pain, and vomiting
Kidney blockage, which may cause problems urinating and/or tiredness and nausea
Diarrhea or constipation, which may continue for weeks to months
Blood in stool, which is the most common symptom of mCRC

These symptoms can be serious. Learn how to discuss them with your care team at your next visit.

Learn about the importance of talking to your doctor about your treatment options with Dr. Al Hallak, a GI medical oncologist.

ViewHide Transcript

VO (Dr. Najeeb Al-Hallak): My name is Doctor Al Halak. I'm a GI medical oncologist from Detroit, MI.
I see colon cancer patients every day in my practice, and I see more and more of those patients that chemotherapy is not an option, either because they are not working or because they tried it and they had side effects. Those patients are in need for more options for treatment.
0:31
Typically for patients who chemotherapy is no longer an option, we have several other options available for them including clinical trial or targeted therapy. However, patients’ preference really is an important aspect of that decision and of course their comorbidities and their performance status.
0:51
A meeting with the patient prior to making that decision is very important to discuss their preference and their need. Maybe they have a travel and hence they prefer an oral agent and so they don't come to the infusion center, or maybe they have work to do, or they have a family condition that they would like to attend to. Those are really important discussions that need to happen with the patients before deciding the treatment options for them beyond chemotherapy.
1:17
When it's the time to switch treatment for patients with colon or rectal cancer, we go over multiple aspects to define that next line of treatment.
Some of those aspects could be related to the colon cancer itself, some will be related to the comorbidities of the patient, some will be the previous side effect profile that they had from previous treatment and some of those will be patient's preference—and we always take the patient's point of view when we discuss the next line of treatment.
If you have colon or rectal cancer, I strongly encourage you to do a research about the treatment options available for you before you meet with your provider.

Biomarker testing

Your doctor may have you complete biomarker testing to understand the specific traits of your cancer.

However, as the first and only treatment for adults with previously treated mCRC, regardless of mutation status—FRUZAQLA may be able to help.

What are common treatment options for metastatic colorectal cancer?

While there is no cure for mCRC, treatment options are available and can help slow the growth of cancer and help manage the symptoms. Take an active role and talk to your doctor about your goals for your next treatment. Goals could look like slowing the growth of cancer to help you live longer, preserving quality of life, or managing the symptoms. No matter what combination of treatments you and your care team choose, the goal is to help you feel as good as you can for as long as you can. It’s important to follow your doctor’s instructions and keep taking your treatment.

You likely have been treated with surgery and/or chemotherapy (chemicals to kill fast-growing cancer cells in your body). But chemotherapy may not be the only option for your next treatment. Other options may include:

Targeted therapies, use drugs or other substances to identify and attack specific types of cancer cells
Immunotherapy, may help your immune system attack and kill your cancer cells
Clinical trials, to explore new treatments that are under investigation to confirm if they may work against mCRC

Your care team will also likely suggest supportive care to help you meet the physical and emotional challenges of colorectal cancer:

Pain
Depression and anxiety
Fatigue and weakness
Loss of appetite
Weight changes
Nausea and vomiting
Constipation
Belly swelling

Ask your doctor if FRUZAQLA is an option to treat your metastatic colorectal cancer

This discussion guide can help you have an informed conversation with your doctor about mCRC. Just download the guide and bring it with you on your visit to help make sure you hit all the important points.

Download the guide

How FRUZAQLA works

Discover what makes FRUZAQLA different.

Explore how it works

Current treatment guidelines for mCRC

See where FRUZAQLA fits in the treatment recommendations for mCRC.

Explore guidelines

FRUZAQLA clinical studies

Discover the data from 2 FRUZAQLA clinical trials.

Explore study results

IMPORTANT SAFETY INFORMATION

FRUZAQLA may cause serious side effects, including:

High blood pressure (hypertension). High blood pressure is common with FRUZAQLA and can also be severe. Your healthcare provider will check your blood pressure before starting treatment with FRUZAQLA, 1 time every week for the first month of treatment, and then at least 1 time a month or more often if needed during treatment. Your healthcare provider may prescribe medicine to treat your high blood pressure if needed. Tell your healthcare provider if you get any of the following symptoms of hypertension during treatment: severe headache, lightheadedness or dizziness, confusion, changes in vision, chest pain, trouble breathing, nosebleeds, or vomiting.

Severe bleeding (hemorrhage). FRUZAQLA can cause bleeding that can be serious and may lead to death. Tell your healthcare provider if you get any of the following symptoms of bleeding during treatment:

unusual, severe, or bleeding that will not stop
bruising
lightheadedness
vomiting blood or your vomit looks like coffee grinds
blood in the stool or black stool that looks like tar
blood in the urine or urine that looks red, pink, or brown
coughing up blood or blood clots
menstrual bleeding that is heavier than normal
unusual vaginal bleeding
nose bleeds that happen often

Infections. FRUZAQLA can increase the risk of infections, including serious infections that can lead to death. The most common infections with FRUZAQLA happened in the urinary tract, nose or throat, and lungs. Tell your healthcare provider if you get any of the following symptoms of infection during treatment: fever, severe cough with or without an increase in mucus (sputum) production, severe sore throat, trouble breathing, burning or pain when you urinate, or redness, swelling, or pain in any part of the body.

A tear in your stomach or intestinal wall (gastrointestinal perforation). FRUZAQLA can cause gastrointestinal perforation that can be serious and may lead to death. Tell your healthcare provider right away if you get any of the following symptoms of gastrointestinal perforation during treatment: severe stomach (abdominal) pain or stomach pain that does not go away, vomiting or vomiting blood, blood in the stool or black stool that looks like tar, fever or chills, or nausea.

Liver problems. Increased liver enzymes in your blood are common with FRUZAQLA and can also be severe and may lead to death. Your healthcare provider will do blood tests before and during treatment with FRUZAQLA to check for liver problems. Tell your healthcare provider if you get any of the following symptoms of liver problems during treatment: yellowing of your skin or the white part of your eyes, dark-colored (tea-colored) urine, pain in your right upper stomach area (abdomen), loss of appetite, nausea or vomiting, or bleeding or bruising.

Protein in your urine (proteinuria). Protein in your urine is common with FRUZAQLA and can also be severe. Your healthcare provider will check your urine for protein before starting and during treatment with FRUZAQLA. Tell your healthcare provider if you have to urinate more than usual or if you get swelling of your face, hands, arms, legs, or feet during treatment.

Hand-foot skin reactions (Palmar-Plantar Erythrodysesthesia [PPE]). Hand-foot skin reactions are common with FRUZAQLA and can also be severe. Tell your healthcare provider if you get a severe rash or redness, pain, blisters, bleeding, or swelling on the palms of your hands or soles of your feet during treatment.

Posterior Reversible Encephalopathy Syndrome (PRES). PRES is a serious condition that can happen in your brain during treatment with FRUZAQLA. Tell your healthcare provider right away if you get any of the following symptoms during treatment: headache, seizures, confusion, changes in vision, or problems thinking.

Wound healing problems. Wounds may not heal properly during treatment with FRUZAQLA. Tell your healthcare provider if you plan to have any surgery before starting FRUZAQLA or during treatment. You should stop taking FRUZAQLA at least 2 weeks before planned surgery. Your healthcare provider will tell you when you may start taking FRUZAQLA again after surgery.

Blood clots in your blood vessels (arteries). FRUZAQLA can cause blood clots or blockage in your blood vessels that may lead to heart attack, stroke, or death. Get medical help right away if you get any of the following symptoms during treatment:

severe chest pain or pressure
pain in your arms, legs, back, neck or jaw
shortness of breath
numbness or weakness of your face, arm, or leg, especially on one side of your body
feeling lightheaded or faint
sweating more than usual
sudden confusion, trouble talking or understanding things
trouble walking
sudden severe headache
sudden vision changes in one or both eyes
dizziness or loss of balance or coordination

Allergic reactions to FD&C Yellow No. 5 and FD&C Yellow No. 6. FRUZAQLA 1mg capsules contain the inactive ingredients FD&C Yellow No. 5 (tartrazine) and FD&C Yellow No. 6 (sunset yellow FCF). FD&C Yellow No. 5 (tartrazine) can cause allergic-type reactions (including bronchial asthma) in certain people, especially people who also have an allergy to aspirin. FD&C Yellow No. 6 (sunset yellow FCF) can also cause allergic reactions. Tell your healthcare provider if you get hives, rash, or trouble breathing during treatment with FRUZAQLA.

The most common side effects of FRUZAQLA include:

voice changes or hoarseness

stomach-area (abdominal) pain

diarrhea

weakness, lack of strength and energy, and feeling very tired or sleepy (asthenia)

FRUZAQLA may cause fertility problems in females, which may affect your ability to have children. Talk to your healthcare provider if you have concerns about fertility.

These are not all of the possible side effects of FRUZAQLA. Call your doctor for medical advice about side effects. You may report side effects to Takeda at 1-844-662-8532 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before taking FRUZAQLA, tell your healthcare provider about all your medical conditions, including if you:

Have high blood pressure.

Have bleeding problems

Have an infection

Have liver or kidney problems

Plan to have surgery or have had recent surgery. You should stop taking FRUZAQLA at least 2 weeks before your planned surgery. Your healthcare provider will tell you when you can start FRUZAQLA again after your surgery

Have recently had a blood clot, stroke, or heart attack

Are allergic to FD&C Yellow No. 5 (tartrazine) or FD&C Yellow No. 6 (sunset yellow FCF)

Are pregnant or plan to become pregnant. FRUZAQLA can harm your unborn baby. You should not become pregnant during treatment with FRUZAQLA.

Females who can become pregnant:

Your healthcare provider will do a pregnancy test before you start treatment with FRUZAQLA.
Use effective birth control (contraception) during treatment and for 2 weeks after your last dose of FRUZAQLA.
Tell your healthcare provider right away if you become pregnant during treatment with FRUZAQLA.

Males with female partners who can become pregnant:

Use effective birth control during treatment and for 2 weeks after your last dose of FRUZAQLA.
Tell your healthcare provider right away if your partner becomes pregnant during your treatment with FRUZAQLA.

Are breastfeeding or plan to breastfeed. It is not known if FRUZAQLA passes into your breast milk. Do not breastfeed during treatment and for 2 weeks after your last dose of FRUZAQLA.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. FRUZAQLA may affect the way other medicines work, and other medicines may affect how FRUZAQLA works.

Especially tell your healthcare provider if you take blood thinners (anticoagulants).

Know the medicines you take. Keep a list of your medicines to show to your healthcare provider and pharmacist when you get a new medicine.