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 of Zhejiang University School of Medicine, was presented as a Late-Breaking Abstract (LBA), marking a significant breakthrough in the treatment landscape of advanced colorectal cancer.During the conference, a reporter from Oncology Frontier conducted an exclusive interview with Professor Ding to discuss the key findings and implications of the study. The following is a summarized version of that interview, shared for our readers’ benefit.
Oncology Frontier: Could you share the background and design rationale of the ANCHOR study?
Professor Kefeng Ding: Our earlier Phase II single-arm exploratory clinical trial demonstrated that the combination of anlotinib with CapeOX chemotherapy achieved a notable objective response rate (ORR) and disease control rate (DCR) in patients with RAS/BRAF wild-type metastatic colorectal cancer, with a favorable safety profile and no unexpected adverse events observed.
Building on these encouraging results, we launched this Phase III randomized controlled trial with a dual aim: first, to address the limited options currently available for first-line treatment of advanced colorectal cancer and offer clinicians more therapeutic choices; and second, to systematically evaluate the role of oral tyrosine kinase inhibitors (TKIs)—specifically anti-angiogenic agents—when combined with chemotherapy across the full continuum of colorectal cancer care, with a focus on their potential for use in the maintenance treatment phase. If maintenance therapy can be effectively achieved using oral agents, it could significantly improve patient compliance and quality of life.
This study adopts a multicenter, randomized, open-label, non-inferiority Phase III trial design. It uses the current standard first-line regimen for advanced colorectal cancer (bevacizumab plus CapeOX) as the control arm and directly compares it head-to-head with the anlotinib plus CapeOX regimen. The rigorous randomized controlled design allows for a more precise evaluation of differences in efficacy and safety between the two treatment approaches, and the study results are expected to provide high-level evidence to guide clinical practice.
Oncology Frontier: What are the efficacy and safety outcomes of this study?
Professor Kefeng Ding: This study enrolled treatment-naïve patients with RAS/BRAF wild-type metastatic colorectal cancer (mCRC), who were deemed unresectable following multidisciplinary team (MDT) evaluation. Participants were randomly assigned in a 1:1 ratio to receive either anlotinib (12 mg once daily, Days 1–14) or bevacizumab (7.5 mg/kg intravenous infusion, Day 1), both in combination with oxaliplatin (130 mg/m², intravenous infusion, Day 1) and capecitabine (850 mg/m² twice daily in the anlotinib group; 1000 mg/m² twice daily in the bevacizumab group, Days 1–14). Each treatment cycle lasted three weeks.
Following 4 to 8 cycles of induction therapy, patients entered a maintenance phase, continuing with anlotinib or bevacizumab plus capecitabine until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) assessed by an Independent Review Committee (IRC). Secondary endpoints included investigator-assessed PFS, objective response rate (ORR), disease control rate (DCR), duration of response (DoR), overall survival (OS), liver metastasis resection rate, and quality of life.
Between May 25, 2021, and August 30, 2023, a total of 748 patients were randomized and included in the intention-to-treat population—373 in the anlotinib group and 375 in the bevacizumab group. The median patient age was 59.0 years, with 227 female participants (30.35%).
With a median follow-up of 25.10 months, the median PFS assessed by the IRC was 11.04 months in both the anlotinib and bevacizumab groups (HR = 1.0), indicating that anlotinib plus CapeOX achieved comparable antitumor efficacy to the standard first-line regimen for advanced colorectal cancer.
In terms of safety, 143 of the 373 patients in the anlotinib group experienced serious adverse events, compared to 129 of 375 in the bevacizumab group, demonstrating a similar safety profile between the two treatment arms.
Oncology Frontier: Does your team plan to explore lower doses or intermittent dosing strategies in the future to improve tolerability?
Professor Kefeng Ding: In the clinical management of advanced colorectal cancer, optimizing treatment during the intensive chemotherapy phase remains challenging. However, the maintenance phase presents greater opportunities for innovation. Our current focus is to establish a balanced treatment framework that ensures sustained disease control while minimizing adverse effects through drug regimen optimization. At the same time, we aim to enhance treatment accessibility and improve patient adherence. Such a shift toward whole-course management represents a meaningful step forward in improving quality of life for cancer patients and holds considerable clinical value.
Oncology Frontier: How would you describe your experience at this year’s ASCO Annual Meeting?
Professor Kefeng Ding: As the most influential academic platform in global oncology, the annual ASCO meeting continues to shape the direction of cancer diagnosis and treatment. This year’s congress showcased cutting-edge developments across multiple tumor types and treatment modalities, highlighting the innovation and momentum within the international oncology community. The event fostered in-depth academic exchange across borders, creating a vibrant and collaborative atmosphere. From keynote presentations and focused symposia to clinical data interpretation and demonstrations of new diagnostic and therapeutic technologies, the meeting was marked by high professionalism and rich academic content. It provided an invaluable opportunity for global dialogue and served as a model for learning and collaboration in cancer care.
Conclusion The ANCHOR study not only breaks through the long-standing bottleneck in first-line treatment options for advanced colorectal cancer, but also pioneers the role of oral TKI-based anti-angiogenic agents in full-course disease management. In particular, the use of oral maintenance therapy significantly enhances patient compliance and quality of life. As Professor Kefeng Ding emphasized during the interview, the study was designed with real-world patient needs in mind. Through multicenter collaboration and a rigorous evidence-based approach, it contributes valuable insights— “Chinese wisdom”—to the global oncology community. From clinical practice to scientific research, the ANCHOR study is poised to “anchor” a new era of more precise and patient-centered care in advanced colorectal cancer.
Expert Profile
Professor Kefeng Ding Professor, Chief Physician, Doctoral Supervisor Executive Deputy Secretary and Party Committee Member, The Second Affiliated Hospital of Zhejiang University School of Medicine
Professor Ding is the Chief Scientist of two major national initiatives: the National Key R&D Program for Chronic Diseases (“Four Major Chronic Diseases”) and the “13th Five-Year Plan” National Key R&D Program. He also serves as the discipline lead for Oncology at Zhejiang University.
With a long-standing focus on surgical oncology and frontline clinical care for colorectal cancer, Professor Ding is recognized as a leading colorectal surgeon in China and a key expert in the development of multidisciplinary diagnostic and treatment systems for colorectal tumors. He has conducted advanced training in hospitals across Japan, Australia, and the United Kingdom.
His clinical and research contributions span early diagnosis and treatment of cancer, surgical oncology, comprehensive management of colorectal cancer, minimally invasive surgery, tumor metastasis, and mechanisms of drug resistance.
He has led numerous national and provincial research projects, including one National Major Science and Technology Project on Chronic Diseases, one National Key R&D Program under the “13th Five-Year Plan,” eight National Natural Science Foundation grants, one Zhejiang Provincial Key R&D Project, and one Zhejiang “Leading Goose” Innovation Program. He has also overseen six clinical trials and published over 50 papers in SCI-indexed journals and leading Chinese core journals in the past five years.
Academic and Professional Roles – Chair, Surgical Subcommittee, Colorectal Tumor Committee, Chinese Medical Doctor Association – Chair, NOSES Committee, Chinese Anti-Cancer Association – Vice Chair, Colorectal Cancer Committee, Chinese Anti-Cancer Association – Standing Committee Member, Oncology Branch, Chinese Medical Association – Chair-Elect, Colorectal Cancer Committee, Zhejiang Anti-Cancer Association – Council Member, Zhejiang Medical Association – Chair-Elect, Surgical Oncology Branch, Zhejiang Medical Association – Chair, Precision Medicine Society
