Immunotherapy in Late-Line Treatment of Colorectal Cancer

Multitargeted tyrosine kinase inhibitors (TKIs), including regorafenib, have modest activity in the late-line treatment of metastatic colorectal cancer. Zanzalintinib is an investigational (not FDA-approved) TKI that targets VEGF, TAM kinases (TYRO3, AXL, and MER) and MET. Promising results combining zanzalintinib with the anti–PD-L1 agent atezolizumab prompted the STELLAR-303 trial, an open-label, randomized, phase 3 trial in chemotherapy-refractory colorectal cancer. Patients with microsatellite-stable metastatic colorectal cancer received 100 mg of oral zanzalintinib daily and 1200 mg of atezolizumab intravenously every 3 weeks (ZA), or received standard-of-care treatment with 160 mg of regorafenib daily on days 1 to 21 every 28 d…