In this OncLive Insights program, Anwaar Saeed, MD, and Daniel Ahn, MD, review the treatment landscape for refractory non-MSI-high metastatic colorectal cancer, discuss the biologic rationale for combining multi-kinase inhibition with immune checkpoint blockade, and examine efficacy, safety, and clinical positioning data from the phase 3 STELLAR 303 trial of zanzalintinib plus atezolizumab, along with future directions including the STELLAR 316 study in minimal residual disease.
Anwaar Saeed, MD, and Daniel Ahn, MD, open this OncLive Insights program with an overview of the current treatment landscape for patients with non-MSI-high metastatic colorectal cancer who have progressed on standard chemotherapy, including fluoropyrimidine-, oxaliplatin-, and irinotecan-based regimens.
Dr. Saeed and Dr. Ahn discuss the biologic features that make non-MSI-high colorectal cancer resistant to immune checkpoint inhibition and the scientific rationale for combining multi-kinase inhibitors with immunotherapy.
Dr. Saeed and Dr. Ahn review what has been learned from early phase trials examining multi-kinase inhibitors combined with immune checkpoint inhibitors in MSS metastatic colorectal cancer, including LEAP-017 and COSMIC-021.
Dr. Saeed presents the design and primary efficacy results of STELLAR 303, the phase 3 trial evaluating zanzalintinib plus atezolizumab versus regorafenib in patients with chemorefractory MSS metastatic colorectal cancer.
Dr. Saeed and Dr. Ahn examine the safety data from STELLAR 303 and discuss practical strategies for managing toxicity in clinical practice.
Dr. Saeed and Dr. Ahn address how zanzalintinib plus atezolizumab fits alongside the expanding array of biomarker-targeted therapies in metastatic colorectal cancer.
Dr. Saeed describes the rationale and design of STELLAR 316, a three-arm phase 3 trial evaluating zanzalintinib-based therapy in patients with stage III MSS colorectal cancer who test positive for circulating tumor DNA following surgery and adjuvant chemotherapy.
Dr. Saeed summarizes the principal clinical lessons from STELLAR 303 and their implications for the management of refractory MSS metastatic colorectal cancer.
