Camrelizumab and apatinib plus induction chemotherapy and concurrent chemoradiotherapy in stage N3 nasopharyngeal carcinoma: a phase 2 clinical trial

Hu Liang, Yao-Fei Jiang, Guo-Ying Liu, Lin Wang, Jian-Wei Wang, Nian Lu, Wei-Xiong Xia, Liang-Ru Ke, Yan-Fang Ye, Jin-Lin Duan, Wei-Xin Bei, Shu-Hui Dong, Wang-Zhong Li, Li-Ting Liu, Chong Zhao (), Changqing Xie () and Yan-Qun Xiang ()
Additional contact information
Hu Liang: Sun Yat-Sen University Cancer Center
Yao-Fei Jiang: Sun Yat-Sen University Cancer Center
Guo-Ying Liu: Sun Yat-Sen University Cancer Center
Lin Wang: Sun Yat-Sen University Cancer Center
Jian-Wei Wang: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy
Nian Lu: Sun Yat-Sen University Cancer Center
Wei-Xiong Xia: Sun Yat-Sen University Cancer Center
Liang-Ru Ke: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy
Yan-Fang Ye: Sun Yat-Sen University
Jin-Lin Duan: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy
Wei-Xin Bei: Sun Yat-Sen University Cancer Center
Shu-Hui Dong: Sun Yat-Sen University Cancer Center
Wang-Zhong Li: Sun Yat-Sen University Cancer Center
Li-Ting Liu: Sun Yat-Sen University Cancer Center
Chong Zhao: Sun Yat-Sen University Cancer Center
Changqing Xie: Thoracic and GI Malignancies Branch, National Cancer Institute, National Institutes of Health
Yan-Qun Xiang: Sun Yat-Sen University Cancer Center

Nature Communications, 2024, vol. 15, issue 1, 1-8

Abstract: Abstract The antiangiogenic agent apatinib has been shown to clinically improve responses to immune checkpoint inhibitors in several cancer types. Patients with N3 nasopharyngeal carcinoma have a high risk of distant metastasis, however, if the addition of immunotherapy to standard treatment could improve efficacy is unclear. In this phase II clinical trial (ChiCTR2000032317), 49 patients with stage TanyN3M0 nasopharyngeal carcinoma were enrolled and received the combination of three cycles of induction chemotherapy, camrelizumab and apatinib followed by chemoradiotherapy. Here we report on the primary outcome of distant metastasis-free survival and secondary end points of objective response rate, failure-free survival, locoregional recurrence-free survival, overall survival and toxicity profile. After induction therapy, all patients had objective response, including 13 patients (26.5%) with complete response. After a median follow-up of 28.7 months, the primary endpoint of 1-year distant metastasis-free survival was met for the cohort (1-year DMFS rate: 98%). Grade≥3 toxicity appeared in 32 (65.3%) patients, with the most common being mucositis (14[28.6%]) and nausea/vomiting (9[18.4%]). In this work, camrelizumab and apatinib in combination with induction chemotherapy show promising distant metastasis control with acceptable safety profile in patients with stage TanyN3M0 nasopharyngeal carcinoma.

Date: 2024
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DOI: 10.1038/s41467-024-45126-0

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