|Category of treatment||Clinical trial or study|
Bevacizumab, capecitabine, and atezolizumab (anti-PD-L1) (NCT0287319)|
Bevacizumab and capecitabine, pembrolizumab (anti-PD-1) (NCT03396926)
Lenvatinib and pembrolizumab (anti-PD1) (NCT03797326)
Cetuximab, FOLFOX, and avelumab (anti-PD-L1) (NCT03174405)
|Regorafenib with CPI||
Regorafenib and nivolumab (anti-PD1) (NCT03406871, NCT03712943, NCT04126733).|
Regorafenib and avelumab (anti-PD-L1) (NCT03475953)
The combination of regorafenib with a checkpoint inhibitor (anti-PD1 or anti-PD-L1) in phase 1/2 trials in Japan (NCT03406871), France (NCT03475953), and the USA (NCT03712943, NCT04126733) resulted in slightly higher percentage of patients who survive beyond 1 year and partial response or stable disease in approximately 40% to 90% of the patients depending on the trial.
|Radiation with regorafenib, CPI, or as monotherapy||
Stereotactic body radiation therapy (SBRT) with ipilimumab (anti-CTLA-4) and nivolumab (anti-PD1). This is a trial in refractory MSS-mCRC adding two checkpoint inhibitors to localized radiation therapy (NCT03104439) called stereotactic body radiation therapy or SBRT (often conceptualized as an “in-situ” vaccine that stimulates a T cell response to the irradiated tumor) resulted in modest disease control rates. It included one complete response which was unexpected with radiation treatment alone.|
SBRT with regorafenib. An mCRC patient with liver metastases taking regorafenib who also received SBRT experienced a durable progression-free survival over 3 years .
SBRT monotherapy. In another study, three mCRC patients also experienced complete responses to SBRT after several prior treatments .