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Zanzalintinib is an orally bioavailable, next-generation small molecule tyrosine kinase inhibitor (TKI) that targets multiple receptor tyrosine kinases implicated in tumor angiogenesis, metastasis, and immunosuppression. Its primary molecular targets include hepatocyte growth factor receptor (c-Met; HGFR), vascular endothelial growth factor receptor type 2 (VEGFR2), and the TAM family kinases AXL and MER. By inhibiting these kinases, zanzalintinib blocks key signaling pathways involved in tumor cell proliferation, survival, invasion, angiogenesis, metastasis, and immune evasion. This results in antiangiogenic and antineoplastic effects as well as modulation of the tumor immune microenvironment. Zanzalintinib is being developed by Exelixis for use primarily in advanced or metastatic renal cell carcinoma—including both clear cell (ccRCC) and non-clear-cell subtypes—as well as colorectal cancer (CRC) and squamous cell carcinoma of the head and neck (SCCHN). It is currently under investigation in phase 3 clinical trials both as monotherapy and in combination with immune checkpoint inhibitors[1][2][4][5][6][7].
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