Anlotinib Adds ~4 Months PFS to STUPP in Newly Diagnosed GBM

Anlotinib, an oral VEGFR/FGFR/PDGFR multi-kinase inhibitor, was combined with standard chemoradiation (temozolomide + 54–60 Gy RT) in a double-blind, multicenter phase II trial (n = 153). Versus placebo, anlotinib prolonged IRC-assessed median PFS from 5.85 mo to 9.89 mo(HR 0.59; p = 0.004) and lifted ORR to 17% vs 5%. Grade ≥3 toxicities were mostly hematologic (thrombocytopenia 8%, neutropenia 6%) and hypertension 5%, adding modest risk to the Stupp backbone. Historical RT + temozolomide yields ~6.7 mo PFS, while adding bevacizumab pushed PFS to 10.6 mo without an OS win—placing anlotinib’s benefit in the same ballpark but with fewer vascular AEs.