A Study of Botensilimab and Balstilimab for Colorectal Cancer With ctDNA+ After Surgery and Chemotherapy
Phase II Study of Adjuvant Botensilimab in Combination With Balstilimab in Patients With Colorectal Cancer and Persistent Circulating Tumor DNA Following Surgery and Chemotherapy
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
Not stated in the study description — ask the study team about visits and procedures.
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This study tests botensilimab and balstilimab together, followed by balstilimab alone. It is for adults with MSS colorectal cancer, a type of colon or rectal cancer, including cancer that spread to the liver. After standard treatment, they must still have cancer DNA in their blood.
The researchers are doing this study to find out whether the combination of botensilimab and balstilimab (BOT/BAL), followed by balstilimab alone, is an effective treatment for people with microsatellite stable (MSS) colorectal cancer or colorectal liver metastases (CRLM) who have measurable residual disease (MRD) after standard treatment with surgery and chemotherapy or total neoadjuvant therapy (TNT).
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Be age 18 or older, with colon or rectal cancer confirmed by a tissue or cell test.
- Have the required MSS/pMMR test result, which describes how cancer cells repair DNA.
- Have finished the required treatment for stage III cancer or cancer that spread to the liver. This usually includes complete surgery and chemotherapy; some other treatment paths are allowed.
- Have a positive ctDNA test, meaning cancer DNA is found in the blood after treatment. Sign consent within 6 weeks after the result is reported.
- Be fully active or able to do light work despite some limits on hard physical activity.
- Have blood counts, kidney function, and liver function that meet the study's limits.
- You or your legal representative must give written consent. Agree to research blood draws, use of stored tissue, and tumor gene testing if not already done.
- If you or your partner could become pregnant, use effective birth control from screening until at least 5 months after the last dose.
Who can't join
- Currently have cancer that has spread or returned, cancer left at the edge of removed tissue, or certain POLE or POLD gene changes.
- Have used another study treatment or device within 4 weeks, or had chemotherapy, targeted drugs, or radiation within 2 weeks before treatment starts. You must also recover enough from prior treatment or major surgery.
- Have had drugs that block PD-1, PD-L1, or CTLA-4, or have an allergy to either study drug or its ingredients.
- Have a weak immune system or used medicines that weaken it within 7 days before treatment starts. Certain short-term, low-dose or inhaled steroids are allowed.
- Have active autoimmune disease, where the immune system attacks the body, or needed whole-body treatment for it within 2 years. Some skin and thyroid conditions are exceptions. Past or current lung swelling not caused by infection also excludes you.
- Have an infection needing whole-body treatment, active TB, uncontrolled HIV, or active hepatitis B or C. Some people with treated, controlled HIV or hepatitis may qualify. A live vaccine within 30 days also excludes you.
- Are pregnant, breastfeeding, or planning to become pregnant or father a child during the study or within 90 days after the last dose.
- Have another health condition, mental health condition, substance use problem, or test result that could make participation unsafe or prevent you from following study requirements.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria: * Subject or legally authorized representative, is willing and able to provide written informed consent. * Histologically- or cytologically- confirmed colorectal cancer. * ≥ 18 years of age on day of signing informed consent. * Consent for use of archival tissue and blood draws for research purposes. * Performance status of ECOG 0 or 1. * Known non-MSI-H/pMMR by IHC, PCR or NGS testing. MSKCC confirmation of non-MSI-H/pMMR status is not mandatory prior to enrollment and treatment on the study. For patients with outside testing, if sufficient tissue is available testing may be repeated at MSKCC and will not impact initial eligibility. * Consent to undergo MSK IMPACT or NGS, if not previously done * Disease specific criteria: 1. Cohorts 1a and 2a: Undergone a complete surgical resection (R0) for stage III colon or rectal cancer, followed by adjuvant chemotherapy with FOLFOX or CAPEOX. Post-operative chemotherapy not required if received previous oxaliplatin-based therapy. Total Neoadjuvant Therapy for rectal cancer with complete clinical and radiographic response is allowed. 2. Cohorts 1b and 2b: Undergone a complete surgical resection (R0) for liver metastasis (ablation or stereotactic body radiation therapy \[SBRT\], but not Y-90, is permitted) and completed standard peri-operative chemotherapy. Peri-operative chemotherapy not required if received previous oxaliplatin-based therapy. Prior floxuridine via Hepatic Arterial Infusion Pump is permitted. Completed definitive treatment for the primary tumor including (R0) resection, or Total Neoadjuvant Therapy for rectal cancer with complete clinical and radiographic response. * Positive ctDNA following completion of appropriate standard of care therapy. * Patients must sign informed consent within 6 weeks of positive ctDNA result. The 6 weeks is considered from the date that the ctDNA is resulted, and not the date it is drawn. Adequate organ function, defined as: 1. Absolute Neutrophil Count ≥ 1,500/mm3. 2. Platelet count ≥ 75,000/mm3. 3. Hemoglobin ≥ 9.0 g/dL 4. Creatinine clearance (CrCl) ≥60 mL/min. 5. AST and ALT ≤ 2.5 × ULN 6. Bilirubin ≤ 1.5 × ULN or Direct bilirubin ≤ ULN * Subjects of childbearing potential (or with partners of childbearing potential) must use effective contraception for the course of the study starting with the screening visit through at least 5 months after the last dose of study treatment. Appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives, or double barrier method (diaphragm plus condom). Exclusion Criteria: * Presence of metastatic or recurrent disease. * Known DNA polymerase epsilon (POLE) or DNA polymerase delta (POLD) activating mutation. * R1 (microscopic residual tumor) or R2 resection (macroscopic residual tumor at resection margin). * Currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment. * Diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment. 1. Patients who have received acute, low dose, systemic immunosuppressant medications (e.g., dexamethasone containing antiemetic regimen or steroids as CT scan contrast premedication) may be enrolled. 2. The use of inhaled corticosteroids and mineralocorticoids (e.g., fludrocortisone) for patients with orthostatic hypotension or adrenocortical insufficiency is allowed. * Hypersensitivity to botensilimab or balstilimab or any of its excipients. * Chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent a. Note: If subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy. * History of, or any evidence of active, non-infectious pneumonitis. * Active infection requiring systemic therapy. * Current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator. * Known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial. * Pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 90 days after the last dose of trial treatment. * Prior therapy with an anti-PD-1, anti-PD-L1, or anti-CTLA-4 agent. * Active autoimmune disease or history of autoimmune disease that required systemic treatment within 2 years of the start of study treatment (i.e., with use of disease-modifying agents or immunosuppressive drugs). The following are exceptions: 1. Subjects with vitiligo or alopecia 2. Subjects with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement or psoriasis not requiring systemic treatment * Known active TB (Bacillus tuberculosis). * Uncontrolled infection with human immunodeficiency virus (HIV). Patients on stable highly active antiretroviral therapy with undetectable viral load and normal CD4 counts for at least 6 months prior to study entry are eligible. Serological testing for HIV at screening is not required * Known to be positive for hepatitis B virus (HBV) surface antigen, or any other positive test for HBV indicating acute or chronic infection. Patients who are receiving or who have received anti-HBV therapy and have undetectable HBV DNA prior to study entry are eligible. Serological testing for HBV at screening is not required. * Known active hepatitis C virus (HCV) as determined by positive serology and confirmed by polymerase chain reaction (PCR). Patients on or who have received antiretroviral therapy are eligible provided they are virus-free by PCR for at least 6 months prior to study entry. Serological testing for HCV at screening is not required. * Received a live vaccine within 30 days of planned start of study therapy
Study sites (7)
NJ
- Memorial Sloan Kettering Basking Ridge (Limited Protocol Activities) · Basking Ridge, NJ 07920Neil Segal, MD, PhD · Study contact · 646-888-4187More trials in Basking Ridge
- Memorial Sloan Kettering Monmouth (Limited Protocol Activities) · Middletown, NJ 07748Neil Segal, MD, PhD · Study contact · 646-888-4187More trials in Middletown
- Memorial Sloan Kettering Bergen (Limited Protocol Activities) · Montvale, NJ 07645Neil Segal, MD, PhD · Study contact · 646-888-4187More trials in Montvale
NY
- Memorial Sloan Kettering Commack (Limited Protocol Activities) · Commack, NY 11725Neil Segal, MD, PhD · Study contact · 646-888-4187More trials in Commack
- Memorial Sloan Kettering Westchester (All Protocol Activities) · Harrison, NY 10604Neil Segal, MD, PhD · Study contact · 646-888-4187More trials in Harrison
- Memorial Sloan Kettering Cancer Center (All Protocol Activities) · New York, NY 10065Neil Segal, MD,PhD · Study contact · 646-888-4187Luis Diaz, MD · Study contact · 646-888-4641Neil Segal, MD, PhD · Principal investigatorMore trials in New York
- Memorial Sloan Kettering Nassau (Limited Protocol Activities) · Rockville Centre, NY 11553Neil Segal, MD, PhD · Study contact · 646-888-4187More trials in Rockville Centre