Colorectal cancer has a strong interaction with the immune system as underlined by the high prognostic impact of tumor infiltrating lymphocytes in the tumor core as well as the infiltration margin in the localized setting. However in the metastatic scenario the vast majority of these tumors - the 95% lacking deficiencies in the missmatch repair sustem- demonstrated to be immune-elusive. The new therapeutic bispecific anti-CEA anti CD3 antidobody CEA-TCB is therefore a new, promising immune modulating therapy currently evaluated in clinical studies in colorectal cancer. The CEA-TCB has a 2-to-1 binding ratio, with one domain of the antibody binding directly to CD3 on T cells while the remaining two binding domains simultaneously bind to CEA molecules on the tumor cells. The CEA-TCB induces T-cell­ engagement and activation, with T-cell proliferation at the site of activation. Two phase 1 trials with CEA-TCB have been presented this year, one as a single-drug trial, the other in combination with the PD-L1 inhibitor Azetolizumab, with promising results. The two studies are debated regarding inclusion, results and toxicity. Finally, the future of CEA-TCB and its impact on Colorectal Cancer treatment are discussed in this podcast.The interview to Guillem Argilés (Gastrointestinal Malignancies Program, Vall d’Hebron University Hospital, Barcelona, Spain) is conducted by the ESMO Open Editor of multimedia and social media Laurids Poulsen.

Read the abstract on the ESMO Open website: http://dx.doi.org/10.1136/esmoopen-2018-000377.