Phase II study of perioperative camrelizumab and XELOX for locally advanced gastric or gastroesophageal junction adenocarcinoma

卡培他滨 医学 奥沙利铂 围手术期 内科学 新辅助治疗 临床终点 不利影响 腺癌 胃肠病学 人口 实体瘤疗效评价标准 肿瘤科 临床研究阶段 化疗 外科 临床试验 癌症 结直肠癌 环境卫生 乳腺癌
作者
Jiaxing He,Bo Zhang,Shuai Zhou,Ying Yang,Zhuo Han,Tao Wu,Qing Qiao,Haicheng Yang,Xianli He,Nan Wang
出处
期刊:Cancer Science [Wiley]
标识
DOI:10.1111/cas.16425
摘要

Abstract Immune checkpoint inhibitors combined with chemotherapy have shown promising efficacy in treating gastric or gastroesophageal junction (G/GEJ) adenocarcinoma in the neoadjuvant setting. This phase II trial (NCT05715632) aimed to investigate the efficacy and safety of perioperative camrelizumab plus XELOX in patients with locally advanced G/GEJ adenocarcinoma. Treatment‐naive patients with cT3‐4aN1‐3 M0 resectable locally advanced G/GEJ adenocarcinoma were recruited to receive camrelizumab (200 mg, intravenously) on Day 1 combined with XELOX (oxaliplatin at 130 mg/m 2 on Day 1 and capecitabine at 1000 mg/m 2 on Days 1–14) every 3 weeks for four cycles, followed by surgery and adjuvant camrelizumab combined with XELOX every 3 weeks for four cycles. The primary endpoint was the pathological complete response (pCR; ypT0N0) rate. From September 2020 to January 2023, 46 patients were enrolled, and all patients completed neoadjuvant therapy. Among them, 43 underwent D2 resection. In the intention‐to‐treat population, pCR was achieved in nine patients (19.6%, 95% confidence interval [CI]: 9.9%–34.4%), and the major pathological response was achieved in 25 patients (54.3%, 95% CI: 39.2%–68.8%). The objective response rate was 69.6%, of which 12 patients achieved a complete response and 20 patients achieved a partial response. The 1‐year event‐free survival and disease‐free survival rates were both 93.1%. Treatment‐related adverse events (TRAEs) occurred in 42 (91.3%) patients, and grade 3 TRAEs occurred in nine (19.6%) patients. No grades 4–5 TRAEs were observed. Perioperative camrelizumab combined with XELOX showed promising pathological response with an acceptable safety profile in patients with resectable locally advanced G/GEJ adenocarcinoma.

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