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Efficacy and Biomarker Analysis of Camrelizumab in Combination with Apatinib in Patients with Advanced Nonsquamous NSCLC Previously Treated with Chemotherapy

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单位: [1]Tongji Univ, Shanghai Pulm Hosp, Dept Med Oncol, Shanghai, Peoples R China [2]Zhejiang Univ, Dept Oncol, Affiliated Hosp 1, Hangzhou, Peoples R China [3]Beijing Canc Hosp, Dept Oncol, Beijing, Peoples R China [4]Harbin Med Univ Canc Hosp, Dept Oncol, Harbin, Peoples R China [5]Jiangxi Canc Hosp, Thorac Tumor Radiotherapy Dept, Nanchang, Jiangxi, Peoples R China [6]Anhui Med Univ, Dept Oncol, Affiliated Hosp 1, Hefei, Peoples R China [7]Sichuan Univ, Dept Thorac Oncol, West China Hosp, Chengdu, Peoples R China [8]Guangzhou Med Univ, Dept Thorac Surg, Affiliated Hosp 1, Guangzhou, Peoples R China [9]Hunan Canc Hosp, Dept Med Oncol, Changsha, Peoples R China [10]Henan Canc Hosp, Dept Oncol, Zhengzhou, Peoples R China [11]Jiangsu Canc Hosp, Dept Med Oncol, Nanjing, Peoples R China [12]Jiangsu Inst Canc Res, Nanjing, Peoples R China [13]Nanjing Med Univ, Affiliated Canc Hosp, Nanjing, Peoples R China [14]Linyi Canc Hosp, Dept Oncol, Linyi, Shandong, Peoples R China [15]Zhejiang Canc Hosp, Dept Thorac Oncol, Hangzhou, Peoples R China [16]Jilin Canc Hosp, Dept Med Oncol, Changchun, Peoples R China [17]Xi An Jiao Tong Univ, Affiliated Hosp 1, Dept Med Oncol, Xian, Peoples R China [18]Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Oncol, Wuhan, Peoples R China [19]Jiangsu Prov Hosp, Dept Oncol, Nanjing, Peoples R China [20]Fujian Med Univ Union Hosp, Dept Oncol, Fuzhou, Peoples R China [21]Shandong Canc Hosp, Dept Oncol, Jinan, Peoples R China [22]Jiangsu Hengrui Med Co Ltd, Dept Clin Res & Dev, Shanghai, Peoples R China [23]Genecast Precis Med Technol Inst, Beijing, Peoples R China [24]Univ Kansas Med Ctr KUMC, Div Med Oncol, Univ Kansas Canc Ctr KUCC, Dept Internal Med,Dept Canc Biol, Overland Pk, KS USA
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Purpose: Our preclinical work suggests that appropriate angiogenesis inhibition could potentiate PD-1/PD-L1 blockade via alleviating hypoxia, increasing infiltration of CD8(+) T cells and reducing recruitment of tumor-associated macrophages. We hereby conducted a clinical trial to evaluate this combination in pretreated patients with advanced non-small cell lung cancer (NSCLC). Patients and Methods: The study included phase Ib apatinib dose-escalation and phase II expansion cohorts. Patients received apatinib at doses of 250-500 mg orally once daily, in combination with camrelizumab 200 mg intravenously every 2 weeks. Results: From March 2017 to October 2018, 105 chemotherapy-pretreated patients with nonsquamous NSCLC were enrolled and received apatinib 250 mg (recommended phase II dose) and camrelizumab. Among them, one (1.0%) complete response, 28 (26.7%) partial responses, and 48 (45.7%) stable diseases were observed. In the efficacy-evaluable population (n = 94), objective response rate (ORR) was 30.9% [95% confidence interval (CI), 21.7-41.2]. The median progression-free survival was 5.7 months (95% CI, 4.5-8.8) and overall survival was 15.5 months (95% CI, 10.9-24.5). Efficacy of combination therapy was evident across all PD-L1 and tumor mutation burden subgroups, and appeared to be improved in patients with STK11/KEAP1 mutation (mutant vs. wild-type, ORR: 42.9% vs. 28.1%; 1-year survival rate: 85.1% vs. 53.1%). No unexpected adverse events were observed. Conclusions: Combined apatinib and camrelizumab showed encouraging antitumor activity and acceptable toxicity in chemotherapy-pretreated patients with advanced nonsquamous NSCLC. Patients with STK11/KEAP1 mutation might derive more benefits from this combination. We will validate these results in an ongoing phase III trial (NCT04203485).

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出版当年[2020]版:
大类 | 1 区 医学
小类 | 1 区 肿瘤学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 肿瘤学
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出版当年[2019]版:
Q1 ONCOLOGY
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Q1 ONCOLOGY

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第一作者单位: [1]Tongji Univ, Shanghai Pulm Hosp, Dept Med Oncol, Shanghai, Peoples R China
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通讯机构: [1]Tongji Univ, Shanghai Pulm Hosp, Dept Med Oncol, Shanghai, Peoples R China [*1]Tongji Univ, Shanghai Pulm Hosp, Shanghai 200433, Peoples R China
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