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Serplulimab + decitabine + oxaliplatin + capecitabine is an investigational neoadjuvant combination regimen being evaluated for the treatment of locally advanced colorectal cancer. This multi-drug strategy combines the PD-1 inhibitor serplulimab with the hypomethylating agent decitabine and the CAPOX chemotherapy backbone (oxaliplatin and capecitabine). Serplulimab is a monoclonal antibody that blocks the PD-1 immune checkpoint to restore anti-tumor T-cell activity. Decitabine, a DNA methyltransferase inhibitor, acts as an epigenetic sensitizer intended to enhance tumor immunogenicity and improve the response to immunotherapy, particularly in pMMR/MSS tumors that are typically resistant to checkpoint blockade. Oxaliplatin and capecitabine provide cytotoxic effects and induce immunogenic cell death, further priming the tumor microenvironment for an immune response. The regimen is currently being studied in Phase II clinical trials sponsored by the Tianjin Medical University Cancer Institute and Hospital.
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