Fruquintinib Plus Capecitabine as Maintenance Treatment of RAS / BRAF Wild-type Metastatic Colorectal Cancer

Inclusion Criteria:

* Patients with histologically confirmed metastatic colorectal adenocarcinoma;
* 18-75 years old;
* Eastern Cooperation Oncology Group (ECOG) performance score 0-1;
* At least one evaluable lesion for disease assessment according to RECIST version 1.1;
* Able to take oral medications;
* Patient have achieved CR, PR or SD after up to 8 cycles of first-line standard FOLFOX / - FOLFIRI / XELOX / xeliri + cetuximab treatment, and remained unresectable;
* If radiotherapy has been performed before enrollment, at least one lesion should be located outside the radiation field;
* Adequate organ functions as assessed by the following laboratory requirements: Leukocytes≥3.0x10\^9/L, absolute neutrophil count≥1.5x10\^9/L, platelet count≥100x10\^9/L, hemoglobin≥9g/dL; serum bilirubin≤1.5x the upper limit of normal(ULN);Alanine aminotransferase(ALT) and aspartate aminotransferase(AST)≤2.5x ULN; serum creatinine≤1.5x ULN.
* An expected survival of at least 12 weeks;
* Fertile male or female patients volunteered to use effective contraceptive methods during the study period and within 6 months after the end of treatment;
* Willing to provide written informed consent to study procedures.

Exclusion Criteria:

* Patients who have received fruquintinib;
* Patients who have received TACE within 6 weeks before enrollment;
* Participated in other unapproved or unlisted drug clinical trials in China within 4 weeks before enrollment, and received corresponding experimental drug treatment;
* Patients with dysphagia, active peptic ulcer, intestinal obstruction, active gastrointestinal bleeding, peptic perforation, malabsorption syndrome or uncontrolled intestinal inflammatory diseases;
* International normalized ratio (INR) \> 1.5 or partially activated prothrombin time (APTT) \> 1.5 × ULN；
* The researchers judged clinically significant electrolyte abnormalities;
* At present, the patient has hypertension that cannot be controlled by drugs, which is specified as: systolic blood pressure ≥ 140 mmHg and / or diastolic blood pressure ≥ 90 mmHg;
* Patients currently have poorly controlled diabetes (fasting glucose level is greater than CTCAE grade 2 after regular treatment);
* Have received any surgery or invasive treatment or operation within 4 weeks before enrollment (except venous catheterization, puncture and drainage, etc.);
* Active or uncontrolled severe infection ≥ grade 2 according to National Cancer Institute Common Toxicity (NCI-CTC) criteria;
* Uncontrolled central nervous system metastasis or previous brain metastasis;
* Other malignant tumors in the past 5 years, except for skin basal cell or squamous cell carcinoma after radical surgery, or cervical carcinoma in situ;
* Any kind of concurrent cardiac disease with clinical meanings, such as cardiovascular accident, myocardial infarction, thromboembolism or hemorrhage within 6 months before enrollment, congestive heart failure ≤New York Heart Association (NYHA) class 2; ventricular arrhythmias requiring drug treatment; LVEF \< 50%;
* With positive urine protein and 24-hour urinary protein content\>1g;
* Have a tendency of bleeding or clotting;
* Known human immunodeficiency virus (HIV) infection; known history of clinically significant liver disease, including viral hepatitis;
* The target lesions have received brachytherapy (radioactive particle implantation) within 60 days before admission;
* Unrelieved toxic reactions higher than CTCAE V5.0 grade 1 caused by any previous anti-cancer treatment, excluding hair loss, lymphopenia and neurotoxicity ≤ grade 2 caused by oxaliplatin;
* With any illness or medical conditions that may jeopardize the patient's compliance or interfere the analyses or judgements of study results;
* Pregnancy or lactation at the time of study entry;
* With fertility but refuse to contraception.