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Camrelizumab Plus Carboplatin and Pemetrexed as First-line Treatment for Advanced Non-squamous NSCLC: Extended Follow-up of CameL Phase 3 Trial

Published:January 13, 2023DOI:https://doi.org/10.1016/j.jtho.2022.12.017
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      Abstract

      Introduction

      In CameL phase 3 study (ClinicalTrials.gov, NCT03134872), addition of camrelizumab to first-line chemotherapy significantly improved the progression-free survival in patients with stage IIIB-IV non-squamous NSCLC. Here, we present outcomes after a minimum follow-up of 43.9 months since last patient randomization.

      Methods

      Eligible patients were randomized 1:1 to 4–6 cycles of camrelizumab plus carboplatin and pemetrexed or chemotherapy alone every 3 weeks, followed by maintenance camrelizumab plus pemetrexed or pemetrexed only (n=205 and 207, respectively). Total camrelizumab exposure was up to 2 years.

      Results

      As of January 31, 2022, camrelizumab plus chemotherapy exhibited substantially improved overall survival over chemotherapy alone (median, 27.1 versus 19.8 mo; hazard ratio, 0.72 [95% CI, 0.57–0.92]). In the chemotherapy alone group, 95 (45.9%) patients crossed over to camrelizumab monotherapy. After adjustment for crossover, the survival benefit with camrelizumab plus chemotherapy was more pronounced (adjusted hazard ratio, 0.55 [95% CI, 0.42–0.71]). In camrelizumab plus chemotherapy group, 33 patients completed 2 years of camrelizumab. Objective response rate was 97.0%, with ongoing responses in 17 of the 32 responses (53.1%); and 93.9% (31/33) of patients were alive at data cutoff. Safety profiles were consistent with the previous report, and no obvious evidence of cumulative toxicity was found with long exposure to camrelizumab.

      Conclusions

      Camrelizumab plus carboplatin and pemetrexed provides long-term survival benefit over chemotherapy, with manageable toxicity, as well as remarkable and durable response in patients receiving 2 years of camrelizumab, further supporting camrelizumab combination as first-line treatment for advanced non-squamous NSCLC.

      Keywords