DISCUSSION
hypertension, colon cancer, fatigue
DISEASE PROGRESSION, HYPERTENSION, COLON CANCER
This study is the first to evaluate the efficacy and safety of fruquintinib initial dose‐escalation strategy for elderly patients with refractory mCRC. The mPFS in patients who were treated with this strategy was 3.8 months, and the primary reason for discontinuation of treatment was disease progression. The majority of elderly mCRC patients were able to tolerate a fruquintinib dosage of 4 mg/day, and fatigue was a major AE. Our study suggests that, for elderly patients with refractory mCRC, the fruquintinib dose‐escalation strategy could serve as a promising alternative to the standard 5 mg/day dosing.In the phase III FRESCO study, the average age of the study participants was 54.6 years.In the present study, a dose‐escalation strategy was implemented during the first cycle of treatment, revealing that the majority of elderly patients with mCRC could tolerate a dose of 4 mg/day. Despite the lower intensity dose administered in this study compared with the overall population in the FRESCO study, the survival outcomes observed were similar. The FRESCO study has reported an incidence of 61.1% for grade ≥3 AEs, with 15.1% discontinuing treatment due to AEs.Although hypertension is a frequently reported AE of anti‐VEGF/VEGFR drugs as shown in this study and previously published literature,Currently, limited research has been conducted to investigate the predictive value of GA in elderly colon cancer patients regarding the effectiveness of specific treatment regimens, and the findings have been controversial. A previous study has suggested that normal IADL is associated with better OS outcomes in elderly mCRC patients receiving first‐line therapy.Our study has several limitations, including a small sample size and a single‐arm design. Additionally, the comparison of data between our study and previous studies on regorafenib and TAS‐102 is challenging due to differences in research settings and studied populations. To provide more robust evidence, larger‐scale phase III clinical trials are necessary to validate the results obtained in this study.