Jian-Wei Wang's research while affiliated with Sun Yat-Sen University Cancer Center and other places

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.

Antiangiogenic agent apatinib has shown synergetic antitumoral efficacy in combination with camrelizumab in several solid tumors. Immunotherapy combination with standard treatment regimen was reported benefit in nasopharyngeal carcinoma (NPC), however, N3 patients did not show the benefit. In this phase II clinical trial (ChiCTR2000032317), 49 eligible patients with stage T any N3M0 NPC were enrolled and received the combination of induction chemotherapy, camrelizumab and apatinib followed by chemoradiotherapy. 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 (98%, 95% confidence interval 88–100). The 2-year failure-free survival was 96%. Grade ≥ 3 toxicity appeared in 32 (65.3%) patients, with the most common being mucositis (14[28.6%]) and nausea/vomiting (9[18.4%]). Camrelizumab and apatinib in combination with induction chemotherapy shows promising distant metastasis control with acceptable safety profile in stage T any N3M0 NPC.