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pucotenlimab + capecitabine + oxaliplatin is a combination therapy being investigated for the neoadjuvant treatment of locally advanced rectal cancer (LARC). The regimen consists of pucotenlimab, a humanized IgG4 monoclonal antibody targeting the programmed cell death protein 1 (PD-1) receptor, and the CAPOX chemotherapy regimen, which includes the oral fluoropyrimidine capecitabine and the platinum-based agent oxaliplatin. Pucotenlimab acts as a checkpoint inhibitor, blocking the interaction between PD-1 and its ligands (PD-L1 and PD-L2) to restore T-cell mediated anti-tumor immunity. Capecitabine is converted into 5-fluorouracil in the body, where it inhibits thymidylate synthase to disrupt DNA synthesis. Oxaliplatin induces DNA damage through the formation of intra- and inter-strand cross-links. This combination is specifically being evaluated in the CONVERT-2 trial (NCT06115330) led by Sun Yat-sen University for patients with pMMR/MSS locally advanced rectal cancer, often combined with selective radiotherapy based on tumor response.
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