Phase II Zanzalintinib cMET/VEGFR inhibitor for metastatic clear cell renal cell carcinoma

This single-institution phase II trial evaluates zanzalintinib, a small molecule cMET/VEGFR inhibitor given orally in 28-day cycles, combined with an investigator-chosen bisphosphonate for bone metastases in patients whose clear cell RCC has progressed after immune checkpoint inhibitors. The design assesses treatment tolerability and progression per RECIST with targeted radiation options for symptom management.