Combination Immunotherapy in Colorectal Cancer
Sponsor: Weill Medical College of Cornell University
ClinicalTrials ID:NCT05571293
This pilot study evaluates the safety and efficacy of combining balstilimab (PD-1 inhibitor) and botensilimab (CTLA-4 inhibitor) in colorectal cancer patients before surgery. Eligible participants are 18+, with confirmed adenocarcinoma, and must use contraception if applicable. The study involves 2 or 4 doses of balstilimab and 1 dose of botensilimab, followed by surgery and post-op visits.
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Program Overview
This is a pilot study to see whether a combination of two investigational drugs that target the immune system can be given to people with colorectal cancer before surgically removing the tumor. This study is also being done to see what side effects this combination of drugs has and what effect they have on colorectal cancer. The two monoclonal antibodies are balstilimab, a programmed cell death protein 1 (PD-1) inhibitor, and botensilimab, a cytotoxic T lymphocyte-associated protein 4 (CTLA-4) inhibitor. This study has 3 cohorts. Participants in Cohort A will receive a total of 2 doses of balstilimab and a single dose of botensilimab, both given intravenously (IV), before surgery. Participants in Cohort B and C will receive a total of 4 doses of balstilimab and a single dose of botensilimab, both given intravenously (IV), before surgery. Participants in Cohort C must have dMMR/MSI-High colorectal cancer.
Description
This is a pilot study to assess the feasibility, safety, and efficacy of using a combination of a programmed cell death protein 1 (PD-1) inhibitor (balstilimab) and cytotoxic T lymphocyte-associated protein 4 (CTLA-4) inhibitor (botensilimab) in the neoadjuvant setting in patients with colorectal cancer, prior to resection. This is a single-center, open-label, pilot study in which patients will receive 2 or 4 doses of intravenous (IV) balstilimab (each dose approximately 2 weeks apart), and a single dose of botensilimab IV, prior to resection in patients with colon cancer. Following surgical resection, participants will return to the clinic for 1-2 post-op follow-up visits.
Eligibility Criteria
Inclusion Criteria
- 18 years of age or older
- Histologically, cytologically, or clinically confirmed adenocarcinoma of the colon or rectal cancer as long as there is no plans for neoadjuvant radiation for the patients with rectal cancer. Note: patients can enroll in cohort B while awaiting mismatch repair testing results. If noted to be dMMR/MSI-High, they would be still considered evaluable and moved to cohort C.
- If capable of becoming pregnant, or getting someone else pregnant, must be willing to use highly effective contraception from Screening period through 90 days following the last dose of study drug
Exclusion Criteria
- Metastatic cancer (cancer that has spread to other parts of the body)
- Previous treatment with immune checkpoint inhibitors targeting CTLA-4, PD-1 or PD-L1
- Currently participating in another study and receiving a study drug
- History of severe allergic reactions to immunotherapies
- Pregnant or breastfeeding
- Active infection requiring treatment
- On immunosuppressive medications
- Active cardiovascular disease, such as stroke or myocardial infarction within 6 months of enrollment, unstable angina, congestive heart failure, or serious uncontrolled cardiac arrhythmia requiring medication that may prevent surgery
Participants in Cohort C must be dMMR/MSI-High.
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