https://doi.org/10.55788/68905840
Several combinations of chemotherapy and immunotherapy are being evaluated as first-line treatment for patients with stage II–IV NSCLC. The phase 3 CameL-sq trial (NCT03668496) compared camrelizumab, a PD-1 inhibitor, plus carboplatin/paclitaxel versus placebo plus carboplatin/paclitaxel in patients with squamous NSCLC. Interim results revealed significantly prolonged progression-free survival (PFS: median 8.5 vs 4.9 months; P<0.0001) with camrelizumab plus chemotherapy. Overall survival (OS) data were not yet mature [1]. Now, Prof. Caicun Zhou (Shanghai Pulmonary Hospital, China) presented the results of an updated analysis [2].
The CameL-sq trial randomised 390 patients with previously untreated, stage IIIB/IV squamous NSCLC 1:1 to camrelizumab plus chemotherapy versus placebo plus chemotherapy for 4–6 cycles, followed by maintenance camrelizumab or placebo until progression of disease or unacceptable toxicity. A total of 106 patients in the placebo arm crossed over to camrelizumab maintenance therapy.
At data cut-off, the median follow-up for the camrelizumab plus chemotherapy arm was 23.7 months versus 15.2 months for the placebo plus chemotherapy arm. Median OS was 27.4 versus 15.5 months, respectively (HR 0.57; P<0.0001); OS rate at 36 months was 42.8% and 23.7%, respectively. The OS benefit persisted after adjusting for crossover (HR 0.41; P<0.0001; see Figure). OS improvement was consistent across pre-specified subgroups, including stratification by PD-L1 expression.
Figure: Crossover-adjusted overall survival in CameL-sq [2]
Treatment-related adverse events (grade 3 or more) were observed in 74% of participants in the camrelizumab arm and 71% of participants in the placebo arm.
In conclusion, these updated results continue to demonstrate that the addition of camrelizumab to first-line chemotherapy in patients with squamous, stage III–IV NSCLC benefits survival. “Therefore, these data support camrelizumab plus chemotherapy as a standard first-line treatment option for advanced squamous NSCLC,” said Prof. Zhou.
- Ren S, et al. J Thorac Oncol. 2022;17:544–557.
- Zhou C, et al. First-line camrelizumab plus carboplatin and paclitaxel for advanced squamous non-small cell lung cancer: Updated overall survival results from the phase III CameL-sq trial. Abstract 3MO. ELCC 2022 Virtual Meeting, 30 March–02 April.
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Table of Contents: ELCC 2022
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