BAL/BOT/agenT-797 in pMMR CRC With Liver Metastases

Inclusion Criteria: * Adults ≥18 years of age with histologically confirmed metastatic colorectal cancer with liver metastases, including evidence of active liver disease if previously treated locally * At least one measurable lesion per RECIST v1.1, with ≥1 target lesion in the liver * Tumor confirmed as microsatellite stable (MSS)/proficient mismatch repair (pMMR) * Received ≥1 prior line of systemic therapy including fluorouracil, oxaliplatin, and irinotecan (not necessarily in combination), and prior EGFR inhibitor or bevacizumab if eligible, unless contraindicated * ECOG performance status 0-1 and life expectancy ≥12 weeks * Adequate organ and marrow function: * ANC ≥1.5 × 10⁹/L * Platelets ≥100 × 10⁹/L * Hemoglobin ≥8 g/dL * AST/ALT ≤2.5 × ULN * Total bilirubin ≤1.5 × ULN * Creatinine clearance ≥30 mL/min * Albumin ≥3 g/dL * PT/PTT ≤1.5 × ULN * Willing and able to provide written informed consent * Negative pregnancy test for women of childbearing potential * Agreement to use effective contraception during study participation Exclusion Criteria: * Tumor is dMMR/MSI-high * Prior treatment with PD-1, PD-L1, CTLA-4 inhibitors, or other immunotherapy agents * Evidence of bowel obstruction, impending obstruction, or recent obstruction (within 3 months) * Refractory ascites requiring frequent paracentesis or recent escalation of diuretics * Clinically significant cardiovascular disease (e.g., recent myocardial infarction or stroke, unstable angina, NYHA cl…