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A recent phase 1 trial has shown promising results in the potential use of immunotherapy to treat colorectal cancer, specifically focusing on microsatellite stable metastatic colorectal cancer (MSS mCRC). The study, published in Nature Medicine, used the immunotherapy drugs botensilimab and balstilimab, which have previously shown consistent and durable responses in difficult-to-treat patients. While immunotherapy has been successful in patients with specific mismatch repair deficient (dMMR) tumours, it has not been effective in those with more common MSS mCRC tumours. This trial marks the first time that immunotherapy has shown promise in treating all forms of colorectal tumours, potentially revolutionizing treatment for this common type of cancer.

Led by Professor Justin Stebbing of Anglia Ruskin University (ARU), the study involved treating a group of patients in the United States with a combination of botensilimab and balstilimab, both monoclonal antibodies that activate the body’s immune system to attack cancer cells. Of the 101 patients who participated in the six-month follow-up, 61% experienced either a decrease in tumour size or stable disease after receiving the combination treatment. The most common side effects reported were diarrhea and fatigue. These results are being hailed as an exciting breakthrough in the field of colorectal cancer treatment, offering hope for patients with MSS mCRC who have not responded well to traditional therapies.

Justin Stebbing, the lead author of the study, describes the findings as potentially game-changing, given the high prevalence of colorectal cancer globally. The success of this trial has paved the way for further clinical trials to validate these results and potentially gain approval from regulatory authorities such as the FDA in the United States. The researchers are optimistic that this novel approach to immunotherapy could offer new treatment options for patients with MSS mCRC, providing a much-needed breakthrough in the fight against this common form of cancer.

Dr. Andrea Bullock, joint first author of the study, emphasizes the significance of these findings for patients with MSS mCRC, who historically have not responded well to immunotherapy. The combination of botensilimab and balstilimab shows promise in activating the immune response against colorectal cancer cells, offering renewed hope for those diagnosed with this challenging form of cancer. The study’s authors are hopeful that their results will inspire further research in this area and open up new possibilities for treating MSS mCRC patients who have limited options for effective therapies.

Dr. Anthony El-Khoueiry, joint last author of the study, highlights the promising anti-tumour activity of botensilimab in treating immunologically cold tumours such as MSS colorectal cancer. The efficacy demonstrated in this phase 1 trial suggests the potential of botensilimab to engage the body’s immune system in fighting against cancer cells. These results offer new insights into the role of immunotherapy in treating MSS mCRC and pave the way for further investigations into the use of immunotherapy in broader contexts.

Overall, the results of this phase 1 trial offer new hope for patients with colorectal cancer, particularly those with MSS mCRC who have not responded well to conventional treatments. The success of combining botensilimab and balstilimab in activating the immune response against cancer cells demonstrates a potential breakthrough in the field of immunotherapy for colorectal cancer. Further research and clinical trials are needed to validate these findings and explore the full potential of immunotherapy in treating various forms of colorectal tumours, offering promise for improving outcomes and quality of life for patients with this common type of cancer.

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