BOLD-100 treatment induces systemic lipid crosstalk in metastatic colorectal carcinoma patients in a combination treatment with FOLFOX

BOLD-100 (sodium trans -[tetrachlorobis(1H-indazole)ruthenate(III)]) is a clinical-stage anticancer drug candidate that targets glucose-regulated protein (GRP78) and impacts the endoplasmic reticulum (ER) stress responses in cancer cells. Despite expanding knowledge about its multimodal mechanism of action from preclinical studies, little is known about the metabolic effects of BOLD-100 in patients. This study is an exploratory analysis of the blood plasma from a subset of metastatic colorectal carcinoma (mCRC) patients who were participants in a phase 1b/2a dose-escalation study (NCT04421820) using a multi-omics strategy based on proteomic and lipid analyses. BOLD-100 treatment was found to exhibit systemic, dose-dependent effects that were more pronounced on the lipid level compared with the protein level. This study indicates that BOLD-100 affects lipid profiles and influences systemic lipid crosstalk, which, in combination with oxaliplatin, leucovorin, and fluorouracil (FOLFOX) chemotherapy may, at least partially, account for the superior clinical outcomes over established therapies in mCRC patients.