Camrelizumab plus apatinib for previously treated advanced adrenocortical carcinoma: a single-arm phase 2 trial

Yu-Chun Zhu, Zhi-Gong Wei, Jing-Jing Wang, Yi-Yan Pei, Jing Jin, Dong Li, Zhi-Hui Li, Zhe-Ran Liu, Yu Min, Rui-Dan Li, Li Yang, Ji-Yan Liu, Qiang Wei and Xing-Chen Peng ()
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Yu-Chun Zhu: Sichuan University
Zhi-Gong Wei: Sichuan University
Jing-Jing Wang: Sichuan University
Yi-Yan Pei: Sichuan University
Jing Jin: Sichuan University
Dong Li: The General Hospital of Western Theater Command
Zhi-Hui Li: The General Hospital of Western Theater Command
Zhe-Ran Liu: Sichuan University
Yu Min: Sichuan University
Rui-Dan Li: Sichuan University
Li Yang: Sichuan University
Ji-Yan Liu: Sichuan University
Qiang Wei: Sichuan University
Xing-Chen Peng: Sichuan University

Nature Communications, 2024, vol. 15, issue 1, 1-11

Abstract: Abstract Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy with a poor prognosis. Therapeutic options for patients with advanced ACC who have failed standard treatments are limited. Single-agent immunotherapy as a second-line treatment has shown unsatisfactory clinical outcomes. This phase II trial (NCT04318730) evaluated the efficacy and safety of the PD-1 inhibitor camrelizumab combined with the VEGFR inhibitor apatinib in previously treated advanced ACC. The primary endpoint was objective response rate (ORR). The secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. A total of 21 patients with advanced ACC received at least one dose of camrelizumab and apatinib. The ORR was 52% (95% CI, 30−74%), meeting the primary endpoint, and the disease control rate (DCR) was 95% (95% CI, 76−100%). The median PFS was 13.3 months (95% CI, 8.4−NE), and the median OS was 20.9 months (95% CI, 11.0−NE). The most common grade 3−4 treatment-related adverse events were alanine aminotransferase elevation, aspartate aminotransferase elevation, and lymphopenia. Predefined exploratory analyses indicated that patients with higher peripheral blood CXCR3 + CD8 + T cell abundance, lower immunosuppressive CD4 + T cell abundance, and higher overlap of clonotypes between tumor-infiltrating T cells and circulating T cells, were more likely to respond favorably to the combined therapy.

Date: 2024
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DOI: 10.1038/s41467-024-54661-9

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