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阿帕替尼联合卡瑞利珠单抗治疗复发/转移性鼻咽癌:一项前瞻性多中心 II 期研究。

Apatinib combined with camrelizumab in the treatment of recurrent/metastatic nasopharyngeal carcinoma: a prospective multicenter phase II study.

机构信息

Department of Oncology, Affiliated Hospital of Guilin Medical University, Guilin, China.

Department of Radiation Oncology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.

出版信息

Front Immunol. 2024 Jan 3;14:1298418. doi: 10.3389/fimmu.2023.1298418. eCollection 2023.

Abstract

BACKGROUND

Preclinical studies demonstrated that immune checkpoint inhibitors combined with antiangiogenic drugs have a synergistic anti-tumor effect. This present phase II trial aimed to evaluate the efficacy and safety of apatinib combined with camrelizumab in patients with recurrent/metastatic nasopharyngeal carcinoma (RM-NPC).

METHODS

Patients with RM-NPC were administered with apatinib at 250 mg orally once every day and with camrelizumab at 200 mg intravenous infusion every 2 weeks until the disease progressed or toxicity became unacceptable. The objective response rate (ORR) was the primary endpoint, assessed using RECIST version 1.1. Progression-free survival (PFS), overall survival (OS), disease control rate (DCR) and safety were the key secondary endpoints. This study was registered with ClinicalTrials.gov, NCT04350190.

RESULTS

This study enrolled 26 patients with RM-NPC between January 14, 2021 and September 15, 2021. At data cutoff (March 31, 2023), the median duration of follow-up was 16 months (ranging from 1 to 26 months). The ORR was 38.5% (10/26), the disease control rate (DCR) was 61.5% (16/26), and the median PFS was 6 months (IQR 3.0-20.0). The median OS was 14 months (IQR 6.0-21.25). Treatment-related grade 3 or 4 adverse events occurred in seven (26.9%) patients, and comprised anemia (7.7%), stomatitis (3.8%), headache (3.8%), pneumonia (7.7%), and myocarditis (3.8%). There were no serious treatment-related adverse events or treatment-related deaths.

CONCLUSION

In patients with RM-NPC, apatinib plus camrelizumab showed promising antitumor activity and manageable toxicities.

摘要

背景

临床前研究表明,免疫检查点抑制剂联合抗血管生成药物具有协同抗肿瘤作用。本Ⅱ期临床试验旨在评估阿帕替尼联合卡瑞利珠单抗治疗复发性/转移性鼻咽癌(RM-NPC)患者的疗效和安全性。

方法

RM-NPC 患者接受阿帕替尼 250 mg 口服,每天一次,卡瑞利珠单抗 200 mg 静脉输注,每 2 周一次,直至疾病进展或毒性不可接受。客观缓解率(ORR)是主要终点,采用 RECIST 1.1 版评估。无进展生存期(PFS)、总生存期(OS)、疾病控制率(DCR)和安全性是关键次要终点。本研究在 ClinicalTrials.gov 注册,NCT04350190。

结果

本研究于 2021 年 1 月 14 日至 2021 年 9 月 15 日期间纳入 26 例 RM-NPC 患者。截至数据截止日期(2023 年 3 月 31 日),中位随访时间为 16 个月(范围 1-26 个月)。ORR 为 38.5%(10/26),疾病控制率(DCR)为 61.5%(16/26),中位 PFS 为 6 个月(IQR 3.0-20.0)。中位 OS 为 14 个月(IQR 6.0-21.25)。7 例(26.9%)患者发生治疗相关 3 或 4 级不良事件,包括贫血(7.7%)、口腔炎(3.8%)、头痛(3.8%)、肺炎(7.7%)和心肌炎(3.8%)。无严重治疗相关不良事件或治疗相关死亡。

结论

在 RM-NPC 患者中,阿帕替尼联合卡瑞利珠单抗具有良好的抗肿瘤活性和可管理的毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/670e/10795162/4017a16f93da/fimmu-14-1298418-g001.jpg

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