Phase 2 NEST Trial: Neoadjuvant BOT/BAL in Localized Colon Cancer
Neoadjuvant botensilimab plus balstilimab is safe, feasible, and demonstrates meaningful pathologic responses in locally advanced pMMR colon cancer.
The NEST Phase 2 trial evaluated the safety, feasibility, and efficacy of neoadjuvant botensilimab (anti‑CTLA‑4) plus balstilimab (anti‑PD‑1) in patients with non‑metastatic colon cancer, focusing on mismatch‑repair proficient (pMMR) disease. In 24 evaluable patients, 59% achieved >50% pathologic tumor response, 41% had major pathologic response, and 32% achieved pathologic complete response. Treatment was well tolerated with no delays to surgery; no grade 4 treatment‑related adverse events were observed. The study supports further development of BOT/BAL in the neoadjuvant setting for pMMR colorectal cancer.
This study extends immune‑checkpoint therapy to MSS (pMMR) colon cancer—an area with limited treatment options—by showing that neoadjuvant BOT/BAL can achieve deep tumor responses and immune activation without compromising surgical timing.
Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.
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