Cemiplimab With or Without Fianlimab to Treat Older Patients With Localized or Locally Advanced MSI-H Colorectal Cancer

Exclusion Criteria

• •Have received an investigational agent or used an investigational device within 28 days of the first dose of study drug.
• •Have expected to require any other form of systemic or localized antineoplastic therapy while on study.
• •Have had surgery within 28 days of dosing of investigational agent, excluding minor procedures (dental work, skin biopsy, etc.).
• •History of prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA4, or anti-Lag-3 antibodies for any reason in the 5 years proceeding their colorectal cancer diagnosis.
• •Currently using any chronic systemic steroids.
• •Patient has received a live vaccine within 30 days of the first dose of study drug.
• •History of severe hypersensitivity reaction to any monoclonal antibody.
• •Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia, metastatic cancer, or psychiatric illness/social situations that would limit compliance with study requirements.
• •Active autoimmune disease.
• •Any tissue or organ allograft, regardless of need for immunosuppression, including corneal allograft.
• •Patient has a pulse oximetry of \<92% on room air.
• •Patient is on supplemental home oxygen.
• •Has clinically significant heart disease.
• •Cohort B Only: Troponin T (TnT) or troponin I (TnI) \> 2x institutional ULN at baseline.
• •Conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access, that would affect the patient's ability to comply with study visits and procedures.
• •Unwilling or unable to follow the study schedule for any reason
• •Exclusion for Cohort C and D:
• •Have received an investigational agent or used an investigational device within 28 days of the first dose of study drug.
• •Have expected to require any other form of systemic or localized antineoplastic therapy while on study.
• •Currently using any chronic systemic steroids.
• •Patient has received a live vaccine within 30 days of the first dose of study drug.
• •History of severe hypersensitivity reaction to any monoclonal antibody.
• •Any tissue or organ allograft, regardless of need for immunosuppression, including corneal allograft.
• •Patient is pregnant or breastfeeding.
• •Cohort D Only: Troponin T (TnT) or troponin I (TnI) \> 2x institutional ULN at baseline.
• •Conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access, that would affect the patient's ability to comply with study visits and procedures.
• •Participation deemed not in the best interest of the patient.
• •Unwilling or unable to follow the study schedule for any reason.