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卡瑞利珠单抗联合奥沙利铂和替吉奥用于局部晚期胃或胃食管结合部癌新辅助治疗的有效性和安全性:一项Ⅱ期、单臂研究。

Efficacy and safety of camrelizumab combined with oxaliplatin and S-1 as neoadjuvant treatment in locally advanced gastric or gastroesophageal junction cancer: A phase II, single-arm study.

机构信息

Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, QuanZhou City, Fujian, China.

出版信息

Cancer Med. 2024 Feb;13(3):e7006. doi: 10.1002/cam4.7006.

Abstract

PURPOSE

In the present study, we aimed to evaluate the efficacy and safety of camrelizumab combined with oxaliplatin plus S-1 in patients with resectable gastric or gastroesophageal junction cancer.

METHODS

In this single-arm, phase II clinical trial, patients with locally advanced gastric or gastroesophageal junction adenocarcinoma were enrolled to receive three cycles of neoadjuvant camrelizumab and oxaliplatin plus S-1 every 3 weeks, followed by surgical resection and adjuvant therapy with the same regimen. The primary endpoint was pathological complete response (pCR) (ypT0) rate and secondary endpoints were R0 resection rate, total pCR (tpCR, ypT0N0) rate, major pathological response (MPR) rate, downstaging, objective response rate (ORR), disease control rate (DCR), event-free survival (EFS), overall survival (OS), and safety.

RESULTS

Between September, 2020 and January, 2022, a total of 29 patients were enrolled in the present study, all of whom completed neoadjuvant therapy and underwent surgery. Three (10.3%) (95% CI: 2.2-27.4) patients achieved pCR as well as tpCR, 20 (69.0%) patients had MPR and 28 (96.6%) patients achieved R0 resection. Treatment-emergent adverse events (AEs) of any grade were observed in 24 (82.8%) patients. Immune-related adverse events of any grade were reported in 13 (44.8%) patients, whereas no grade 3 or higher adverse events occurred.

CONCLUSION

The neoadjuvant therapy with camrelizumab in combination with oxaliplatin and S-1 showed a modest pCR rate, and favorable MPR rate and safety profile in patients with gastric or gastroesophageal junction cancer.

摘要

目的

在本研究中,我们旨在评估卡瑞利珠单抗联合奥沙利铂和替吉奥用于可切除胃或胃食管结合部腺癌患者的疗效和安全性。

方法

在这项单臂、Ⅱ期临床研究中,招募局部晚期胃或胃食管结合部腺癌患者接受三周期新辅助卡瑞利珠单抗联合奥沙利铂和替吉奥每 3 周一次,随后进行手术切除,并采用相同方案进行辅助治疗。主要终点是病理完全缓解(ypT0)率,次要终点是 R0 切除率、总病理完全缓解(ypT0N0)率、主要病理缓解(MPR)率、降期、客观缓解率(ORR)、疾病控制率(DCR)、无事件生存(EFS)、总生存(OS)和安全性。

结果

2020 年 9 月至 2022 年 1 月,共纳入 29 例患者,均完成新辅助治疗并接受手术。3 例(10.3%)(95%CI:2.2-27.4)患者达到病理完全缓解(ypT0)和总病理完全缓解(ypT0N0),20 例(69.0%)患者达到 MPR,28 例(96.6%)患者达到 R0 切除。任何级别的治疗相关不良事件(AE)在 24 例(82.8%)患者中观察到。任何级别免疫相关 AE 在 13 例(44.8%)患者中报告,无 3 级或更高级别不良事件发生。

结论

卡瑞利珠单抗联合奥沙利铂和替吉奥的新辅助治疗在胃或胃食管结合部腺癌患者中显示出适度的病理完全缓解率,以及良好的 MPR 率和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c379/10891470/b2ab4c975721/CAM4-13-e7006-g001.jpg

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