Neoadjuvant mFOLFOX6 plus camrelizumab and apatinib in colon cancer and biomarker research via spatiotemporal-omics profiling.

This is a single-arm, phase II clinical trial aimed to evaluate mFOLFOX6 plus camrelizumab and apatinib as a neoadjuvant regimen for locally advanced colon cancer. This trial was registered on ClinicalTrials.gov (NCT04625803), with the registration date of November 30, 2020. The primary endpoint was the pathological response rate (TRG 2-4, Dworak criteria). Time-of-flight, imaging mass cytometry and spatial proteomic analysis was applied to explore efficacy-related predictive biomarkers. Of 12 enrolled patients, 11 underwent surgery. The TRG 2-4 rate was 81.8% overall (87.5% in the MSS subgroup). Five patients (45.5%) achieved pathological complete response (pCR). With a median follow-up of 36.60 months, only one patient relapsed. An increase in the frequency of CD8  T-cells and a decreased frequency of tissue-resident memory 1 (Trm-1) and regulatory T (Treg) cells are associated with a favorable response to neoadjuvant therapy. Spatiotemporal multiomics analysis highlighted tissue-resident macrophages as potential predictive biomarkers and warrants further verification.