Clinical efficacy and safety of camrelizumab combined with apatinib and chemotherapy as second-line or later therapy in the treatment of HER-2 negative advanced gastric cancer
10.3760/cma.j.cn371439-20220111-00051
- VernacularTitle:卡瑞利珠单抗联合阿帕替尼及化疗二线或以上治疗HER-2阴性晚期胃癌的临床疗效及安全性
- Author:
Lin TANG
1
;
Mingyue XIANG
;
Jianbo ZHANG
;
Lili WANG
;
Heyi GONG
;
Dali HAN
Author Information
1. 山东第一医科大学（山东省医学科学院）研究生院，山东第一医科大学附属肿瘤医院肿瘤内科，济南 250117
- Keywords:
Stomach neoplasms;
Drug therapy, combination;
Camrelizumab;
Apatinib
- From:
Journal of International Oncology
2022;49(5):276-281
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy and safety of the camrelizumab combined with apatinib and chemotherapy as second-line or later therapy in human epidermal growth factor receptor-2 (HER-2) negative advanced gastric cancer.Methods:A total of 66 patients with HER-2 negative advanced gastric cancer and first-line treatment failure in Shandong Cancer Hospital Affiliated to Shandong First Medical University from March 2018 to September 2021 were selected. They were divided into study group ( n=22) and control group ( n=44) according to the different treatment regimens. The patients in the study group were treated with camrelizumab combined with apatinib and chemotherapy, and the patients in the control group were treated with chemotherapy alone. The short-term efficacy, progression-free survival (PFS) , overall survival (OS) and the occurrence of adverse reactions were compared, and Cox regression analysis was used to analyze the influencing factors of prognosis. Results:After at least 2-4 cycles of treatment, the ORR in the study group and the control group were 9.1% (2/22) and 0 (0/44) respectively, with no statistically significant difference ( P=0.108) . DCR in the two groups were 77.3% (17/22) and 45.5% (20/44) respectively, with a statistically significant difference ( χ2=6.03, P=0.014) . The study group didn’t reach median OS and the median OS in the control group was 11.7 months, with no statistically significant difference ( χ2=1.59, P=0.207) . The study group didn’t reach median PFS and the median PFS in the control group was 3.2 months, with a statistically significant difference ( χ2=10.13, P=0.001) . Multivariate Cox regression analysis showed that treatment method was an independent influencing factor for PFS in patients with HER-2 negative advanced gastric cancer ( HR=0.33, 95% CI: 0.15-0.75, P=0.008) . In terms of adverse reactions, there was a statistically significant difference in the incidence of elevated alanine aminotransferase between the study group and the control group [31.8% (7/22) vs. 6.8% (3/44) , χ2=5.32, P=0.021]. There were no adverse-related deaths in both groups. Conclusion:Compared with chemotherapy alone, camrelizumab combined with apatinib and chemotherapy as a second-line or later therapy in HER-2 negative advanced gastric cancer can prolong PFS and improve DCR, but the incidence of elevated alanine aminotransferase increases significantly.
