Wang Jiaqiang, Gao Shilei, Yang Yonghao, Liu Xu, Zhang Peng, Dong Shuping, Wang Xin, Yao Weitao
Department of Orthopedics, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan Province, 450008, People's Republic of China.
Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan Province, 450008, People's Republic of China.
Cancer Manag Res. 2021 Dec 3;13:8999-9005. doi: 10.2147/CMAR.S337253. eCollection 2021.
Advanced clear cell sarcoma (CCS) is a rare subtype of sarcoma with few effective treatments. Evidence shows that apatinib is efficacious and safe for CCS. This study aimed to assess the safety and efficacy of apatinib and/or camrelizumab (a PD-1 inhibitor) in treating advanced CCS.
We retrospectively reviewed 12 patients with advanced CCS who received apatinib and/or camrelizumab therapy between November 2018 and July 2021. Standard descriptive statistics were employed for continuous variables and categorical variables (number and percentage).
Of the 12 CCS patients, 3 had a partial response (PR), and 4 had stable disease (SD). Among the 5 patients treated with apatinib monotherapy, 1 PR and 2 SD were found, and the addition or replacement of camrelizumab after progressive disease (PD) did not work. In the 4 patients who received apatinib plus camrelizumab combination therapy, 1 PR and 1 SD were found. All 3 patients who received camrelizumab first had PD, and 1 PR and 1 SD were found after adding apatinib. Grade 3 or 4 adverse events were significantly more common in the apatinib plus camrelizumab combination therapy than in the apatinib or camrelizumab monotherapy, and these included increased aspartate aminotransferase and increased alanine aminotransferase levels.
Apatinib has promising effectiveness for CCS. Camrelizumab efficacy for the treatment of clear cell sarcoma is inconclusive. The efficacy of apatinib and PD-1 inhibitors in CCS need to be further investigated in prospective clinical trials.
晚期透明细胞肉瘤(CCS)是一种罕见的肉瘤亚型,有效治疗方法较少。有证据表明,阿帕替尼对CCS有效且安全。本研究旨在评估阿帕替尼和/或卡瑞利珠单抗(一种PD-1抑制剂)治疗晚期CCS的安全性和疗效。
我们回顾性分析了2018年11月至2021年7月期间接受阿帕替尼和/或卡瑞利珠单抗治疗的12例晚期CCS患者。对连续变量和分类变量(数量和百分比)采用标准描述性统计方法。
12例CCS患者中,3例部分缓解(PR),4例疾病稳定(SD)。在接受阿帕替尼单药治疗的5例患者中,发现1例PR和2例SD,疾病进展(PD)后加用或换用卡瑞利珠单抗均无效。在接受阿帕替尼联合卡瑞利珠单抗治疗的4例患者中,发现1例PR和1例SD。先接受卡瑞利珠单抗治疗的3例患者均出现PD,加用阿帕替尼后发现1例PR和1例SD。3/4级不良事件在阿帕替尼联合卡瑞利珠单抗治疗组比阿帕替尼或卡瑞利珠单抗单药治疗组更常见,包括天门冬氨酸氨基转移酶升高和丙氨酸氨基转移酶水平升高。
阿帕替尼对CCS有良好疗效。卡瑞利珠单抗治疗透明细胞肉瘤的疗效尚无定论。阿帕替尼和PD-1抑制剂在CCS中的疗效需要在前瞻性临床试验中进一步研究。