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BOT + BAL is a combination immunotherapy regimen developed by Agenus, comprising botensilimab (BOT) and balstilimab (BAL). Botensilimab is a next-generation, Fc-enhanced monoclonal antibody targeting CTLA-4, designed to improve upon first-generation CTLA-4 inhibitors by enhancing T-cell priming, promoting regulatory T-cell (Treg) depletion, and activating innate immune cells. Balstilimab is a fully human monoclonal antibody targeting the PD-1 receptor to prevent immune evasion by tumor cells. This dual checkpoint blockade is being investigated for its ability to treat immunologically 'cold' tumors, with significant clinical activity observed in microsatellite stable (MSS) metastatic colorectal cancer, melanoma, and various sarcomas.
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