Astana's Danish rider Jakob Fuglsang crossed the line alone to win the hilly fifth stage of the Tirreno-Adriatico cycling race on Sunday with Britain's Adam Yates holding on to the leader's blue jersey.

Yates, riding for the Mitchelton-Scott team, finished 40sec behind Fuglsang with Slovenian Primoz Roglic of Team Jumbo-Visma third on 56sec after the 180km ride from Colli del Metauro to Recanati.

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The three riders are fighting for victory in the "Race Between Two Seas" across Italy from the Mediterranean to the Adriatic which finishes on Tuesday with Yates 25sec ahead of Roglic and Fuglsang third at 35sec.

Tom Dumoulin dropped a whopping 1min 39sec on the day to sit fourth at 1min 55sec and likely out of the running for the tour win.

Fuglsang's win was the second for Astana after Kazak rider Alexey Lutsenko survived two late crashes to win a sprint finish for the fourth stage.

"We basically tried to do the same thing as yesterday," said Fuglsang, who dedicated the win to former Astana teammate Michele Scarponi, who came from nearby Filottrano, and was killed in a road accident while training two years ago.

"Today was my turn to go from the distance. Luckily it worked out. I wanted to win this stage for Michele Scarponi and his wife who visited us yesterday."

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Sunday's hilly stage covered 180km with sharp ascents including the Muro di San Pietro which has a maximum 20 percent gradient.

"I said yesterday this was going to be the hardest stage of the race and it was," said Yates.

"I came close to the win but Fuglsang was on another level. I realised Roglic was hurting a little bit. I did the best I could but I don't know if 25 seconds advantage will be enough to win Tirreno-Adriatico."

Monday's sixth and penultimate stage which covers 195km from Matelica to Jesi with the wavy but uncomplicated route designed to suit a sprint finish.