Editor's Note: At the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, the ANCHOR study, led by Professor Kefeng Ding from The Second Affiliated Hospital Zhejiang University School of Medicine, was presented as a late-breaking abstract (LBA), injecting new momentum into the treatment landscape for metastatic colorectal cancer (mCRC). On-site, Oncology Frontier interviewed Prof. Ding about the study, and we now present the full discussion for our readers.Oncology Frontier: Could you share the background and design rationale of the ANCHOR study?
Prof. Kefeng Ding: In our previous Phase II single-arm exploratory trial, we observed that the combination of anlotinib and CapeOX chemotherapy demonstrated promising objective response rate (ORR) and disease control rate (DCR) in RAS/BRAF wild-type mCRC patients, with a favorable safety profile and no unexpected adverse events. Based on these findings, we initiated this Phase III randomized controlled study to pursue two key objectives:
First, to address the limited treatment options in the first-line setting for advanced colorectal cancer and offer clinicians more viable alternatives. Second, to systematically evaluate the role of oral tyrosine kinase inhibitors (TKIs)—a class of anti-angiogenic agents—in the full course management of advanced colorectal cancer, particularly in the maintenance phase. If oral agents can effectively support maintenance therapy, this could significantly improve patient adherence and quality of life.
The ANCHOR study employed a multicenter, randomized, open-label, non-inferiority Phase III design. We used the current standard first-line regimen—bevacizumab plus CapeOX—as the control arm and compared it head-to-head with anlotinib plus CapeOX. This rigorous randomized approach enables a more precise comparison of efficacy and safety between the two regimens, offering high-level evidence to support clinical decision-making.
Oncology Frontier: What were the efficacy and safety outcomes of the trial?
Prof. Kefeng Ding: We enrolled previously untreated patients with unresectable RAS/BRAF wild-type mCRC, as assessed by a multidisciplinary team. Patients were randomized 1:1 to either the anlotinib group (12 mg orally once daily, days 1–14) or the bevacizumab group (7.5 mg/kg IV on day 1). Both arms received oxaliplatin (130 mg/m² IV on day 1) and capecitabine (anlotinib group: 850 mg/m²; bevacizumab group: 1000 mg/m², orally twice daily, days 1–14) every 3 weeks. After 4–8 cycles of induction therapy, patients entered the maintenance phase with continued use of either anlotinib or bevacizumab plus capecitabine until disease progression or unacceptable toxicity.
The primary endpoint was progression-free survival (PFS) as assessed by an Independent Review Committee (IRC), with secondary endpoints including investigator-assessed PFS, ORR, DCR, duration of response (DoR), overall survival (OS), liver metastasectomy rate, and quality of life.
Between May 25, 2021, and August 30, 2023, a total of 748 patients were randomized: 373 to the anlotinib arm and 375 to the bevacizumab arm. The median age was 59 years, and 30.35% were female (n=227).
After a median follow-up of 25.1 months, the IRC-assessed median PFS was 11.04 months in both groups (HR = 1.0), demonstrating that anlotinib plus CapeOX achieved non-inferior antitumor efficacy compared to the standard first-line regimen.
In terms of safety, 143 of 373 patients in the anlotinib group experienced serious adverse events (SAEs), compared with 129 of 375 in the bevacizumab group—indicating comparable safety profiles between the two arms.
Oncology Frontier: Will your team explore lower doses or intermittent dosing strategies to improve tolerability in the future?
Prof. Kefeng Ding: Optimizing the therapeutic phase of chemotherapy in advanced colorectal cancer remains a complex challenge. However, the maintenance phase offers greater room for innovation. Our current focus is on balancing efficacy and tolerability: we aim to maintain disease control while minimizing toxicity and enhancing both treatment accessibility and patient adherence. This patient-centered, full-course management strategy has the potential to meaningfully improve quality of life for cancer patients.
Oncology Frontier: How would you describe your overall experience attending this year’s ASCO meeting?
Prof. Kefeng Ding: ASCO remains the most influential academic platform in global oncology. This year’s meeting showcased significant progress across tumor types and treatment modalities, reflecting the vibrant innovation within the international oncology community. The meeting fostered in-depth academic exchange among global experts, creating an intellectually rich and collaborative environment. From plenary sessions to focused symposia, from clinical data interpretation to technological advances, the organization and academic depth of the conference were truly outstanding. It provided an invaluable opportunity for learning and cross-border dialogue in the fight against cancer.
Conclusion
The ANCHOR study not only addresses the limitations of current first-line therapies for advanced colorectal cancer but also offers a novel approach by validating the potential of oral TKIs in full-course treatment strategies. Notably, the use of oral maintenance therapy improves adherence and quality of life. As Prof. Kefeng Ding emphasized, the study was designed with patient needs in mind and represents a significant contribution from China to the global oncology community. With its solid clinical foundation and evidence-based rigor, the ANCHOR study is helping steer advanced colorectal cancer treatment toward a more precise and patient-friendly future.
Professor, Chief Surgeon, Doctoral Supervisor
Executive Deputy Secretary and Party Committee Member, Second Affiliated Hospital of Zhejiang University School of Medicine
Chief Scientist of the National Major Scientific and Technological Project for the “Four Major Chronic Diseases”
Chief Scientist of the National Key R&D Program under China’s 13th Five-Year Plan
Head of the Oncology Degree Program, Zhejiang University
Prof. Kefeng Ding has long been engaged in frontline clinical practice in oncologic surgery, particularly colorectal cancer. He is one of China’s leading colorectal surgeons and a key figure in developing the national multidisciplinary diagnostic and treatment system for colorectal tumors.
He has completed advanced training and academic exchange at leading hospitals in Japan, Australia, and the United Kingdom. His clinical and research contributions span early diagnosis and treatment of cancer, surgical oncology, comprehensive colorectal cancer therapy, minimally invasive surgery, tumor metastasis, and treatment resistance.
He has led one national-level project on chronic diseases, one national key R&D initiative under the 13th Five-Year Plan, eight grants from the National Natural Science Foundation of China, one Zhejiang provincial key R&D program, and one “Leading Goose” provincial innovation project. He has also led six clinical studies and published over 50 papers in SCI-indexed and core domestic medical journals in the past five years.
Prof. Ding serves in leadership roles across several academic and medical societies, including:
• Chair, Surgical Committee of the Colorectal Tumor Professional Committee, Chinese Medical Doctor Association
• Chair, NOSES Professional Committee, Chinese Anti-Cancer Association
• Vice Chair, Colorectal Cancer Professional Committee, Chinese Anti-Cancer Association
• Executive Member, Oncology Branch, Chinese Medical Association
• Chair-elect, Colorectal Cancer Committee, Zhejiang Anti-Cancer Association
• Vice Chair-elect, Surgical Oncology Branch, Zhejiang Medical Association
• Chair, Precision Medicine Society
