Camrelizumab Improves OS Over Chemo in Esophageal Squamous Cell Carcinoma

Phase 3 study findings suggest that second-line camrelizumab significantly improves overall survival (OS) in patients with advanced or metastatic esophageal squamous cell carcinoma (Lancet Oncol. 2020 May 13. Epub ahead of print).

“Patients with advanced or metastatic oesophageal squamous cell carcinoma have poor prognosis and few treatment options after first-line therapy,” said Jing Huang, MD, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, and co-investigators, who evaluated the safety and efficacy of camrelizumab in previously treated patients with this disease.

Between May 10, 2017, and July 24, 2018, a total of 457 pretreated patients with advanced or metastatic esophageal squamous cell carcinoma were enrolled in the open-label study from 43 hospitals across China. These patients were randomized in a 1:1 ratio to receive camrelizumab 200 mg every 2 weeks (n = 228) or chemotherapy comprising docetaxel 75 mg/m² every 3 weeks or irinotecan 180 mg/m² every 2 weeks (n = 220).

The main end point of the study was OS, and as of May 6, 2019 (the point of data cutoff), patients given camrelizumab and chemotherapy had a median follow-up time frame of 8.3 months and 6.2 months, respectively. The median OS was 8.3 months (95% CI, 6.8-9.7) and 6.2 months (95% CI, 5.7-6.9), respectively (hazard ratio, 0.71; 95% CI, 0.57-0.87; 2-sided P = .0010).

The most frequently documented treatment-related adverse events grade ≥3 were anemia (camrelizumab vs chemotherapy: 3% vs 5%), abnormal hepatic function (2% vs <1%, respectively), and diarrhea (1% vs 4%, respectively).

Ultimately, 7 treatment-related deaths occurred in the camrelizumab arm and 3 occurred in the chemotherapy arm.

“Second-line camrelizumab significantly improved [OS] in patients with advanced or metastatic oesophageal squamous cell carcinoma compared with chemotherapy, with a manageable safety profile,” Dr Huang and colleagues concluded.

“It might represent a potential option of standard second-line treatment for patients with oesophageal squamous cell carcinoma in China,” they added.—Hina Porcelli