Neoadjuvant botensilimab with or without balstilimab in pMMR and dMMR colon cancer: the phase 2 UNICORN trial.

In resectable locally advanced colon cancer, preoperative botensilimab plus balstilimab achieved pathological major response rates of 36% in pMMR and 100% in dMMR cohorts.

• Why it matters: First-generation immune checkpoint inhibitors have been considered resistant in proficient mismatch repair colon cancer, limiting early-stage options.
• What they did: In the phase 2 UNICORN trial, 56 patients received short-course preoperative botensilimab alone or with balstilimab, with centrally assessed pathological major response (≤10% residual viable tumor) as the primary endpoint.
• The result: Pathological major response was 0% (95% CI: 0-23.2%) with botensilimab alone in pMMR, while botensilimab plus balstilimab produced responses in both pMMR and dMMR, supporting the combination to expand early-stage ICI benefit.

AI summary of the abstract · may contain errors · not medical advice · read the paper.