Carlos Carrasco, in his second rehab outing, struck out four in 1⅔ hitless innings Thursday for Double-A Akron.
Carrasco threw 42 pitches, 25 for strikes, in a relief appearance against Richmond.
The Cleveland Indians right-hander threw one inning of relief Monday night for Akron against Harrisburg. It was his first outing since being diagnosed in June with chronic myeloid leukemia, a treatable form of cancer.
His teammates -- and Cleveland fans -- have rallied around Carrasco. During the All-Star Game in July, he appeared on the field during Major League Baseball's "Stand Up To Cancer" tribute, and "I Stand With Cookie" T-shirts have become popular around town.
Carrasco, 32, said Monday that he was touched by the support he received from Akron's fans.
"Those people were the ones behind me the whole way, from day one to now," he said.
The Associated Press contributed to this report.