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Neoadjuvant Camrelizumab for Non-Small Cell Lung Cancer: A Retrospective Multicenter, Real-World Study (CTONG2004)

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Abstract

Background

Camrelizumab has shown encouraging efficacy in advanced non-small cell lung cancer (NSCLC), either as monotherapy or combined with chemotherapy. However, evidence of neoadjuvant camrelizumab for NSCLC remains lacking.

Methods

Patients with NSCLC treated with neoadjuvant camrelizumab-based therapy followed by surgery between December 2020 and September 2021 were retrospectively reviewed. Demographic and clinical data, details of neoadjuvant therapy and surgical information were retrieved.

Results

In this multicenter retrospective real-world study, 96 patients were included. Ninety-five patients (99.0%) received neoadjuvant camrelizumab combined with platinum-based chemotherapy, with a median of 2 cycles (range 1–6). The median interval from the last dose to surgery was 33 days (range 13–102 days). Seventy patients (72.9%) underwent minimally invasive surgery. Lobectomy was the most frequent surgical procedure (94 [97.9%]). The median estimated intraoperative blood loss was 100 mL (range 5–1200 mL), and the median operative time was 3.0 h (range 1.5–6.5 h). The R0 resection rate was 93.8%. Twenty-one patients (21.9%) experienced postoperative complications, with the most common being cough and pain (both 6 [6.3%]). The overall response rate was 77.1% (95% CI 67.4–85.0%), and the disease control rate was 93.8% (95% CI 86.9–97.7%). Twenty-six patients (27.1%, 95% CI 18.5–37.1%) had pathological complete response. Neoadjuvant treatment-related adverse events of grade ≥ 3 were reported in seven patients (7.3%), with the most frequent being abnormal liver enzymes (two [2.1%]). No treatment-related deaths were reported.

Conclusion

The real-world data indicated that camrelizumab-based therapy had promising efficacy for NSCLC in the neoadjuvant setting, with manageable toxicities. Prospective studies investigating neoadjuvant camrelizumab are warranted.

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Data availability

The study data are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Lifeng Yin (a statistics manager), Yingmeng Zhang (a former medical manager) and Yanhua Xu (a medical writer) from Jiangsu Hengrui Pharmaceuticals Co., Ltd. for their input in statistical analyses and medical writing.

Funding

The study was funded by the Chinese Thoracic Oncology Group (CTONG).

Author information

Authors and Affiliations

  1. Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China

    Si-Yang Liu & Yi-Long Wu

  2. Department of Thoracic Oncological Surgery, Cancer Hospital of The University of Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China

    Qixun Chen

  3. State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China

    Chengzhi Zhou

  4. Department of Thoracic Surgery, SUN YAT-SEN Memorial Hospital, SUN YAT-SEN University, Guangzhou, 510123, People’s Republic of China

    Huizhong Zhang

  5. Department of Respiratory Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China

    Wen Li

  6. Department of Thoracic Medical Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People’s Republic of China

    Jianhua Chen

  7. Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, People’s Republic of China

    Jian Hu

  8. Second Department of Thoracic Medicine, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People’s Republic of China

    Lin Wu

  9. Department of Thoracic Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China

    Qunqing Chen

  10. Department of Medical Oncology, The First Affiliated Hospital, SUN YAT-SEN University, Guangzhou, 510060, People’s Republic of China

    Qiangsheng Dai

  11. Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China

    Jian-Zhen Shan

  12. Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330209, People’s Republic of China

    Fei Xu

  13. Department of HematologyFirst Affiliated HospitalInstitute of Hematology, School of MedicineKey Laboratory for Regenerative Medicine of Ministry of Education, Jinan University, Guangzhou, 510632, People’s Republic of China

    Si-Yang Maggie Liu

  14. Chinese Thoracic Oncology Group (CTONG), Guangzhou, 510055, People’s Republic of China

    Si-Yang Maggie Liu

Authors
  1. Si-Yang Liu
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  8. Lin Wu
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  14. Yi-Long Wu
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Contributions

Y-LW conceived and designed this study. S-YL, QC, CZ, HZ, WL, JC, JH, LW, QC, QD, J-ZS and FX collected the data. S-YL, S-YML and Y-LW analyzed the data. All authors participated in the data interpretation. S-YL, S-YML and Y-LW drafted the manuscript. All authors participated in reviewing the manuscript and approved the final version of the manuscript.

Corresponding authors

Correspondence to Si-Yang Maggie Liu or Yi-Long Wu.

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Competing interests

Prof. Yi-Long Wu reports personal financial interests: consulting and advisory services, speaking engagements of Roche, AstraZeneca, Eli Lilly, Boehringer Ingelheim, Sanofi, MSD, BMS. The other authors declare that they have no competing interests.

Conflict of interests

Prof. Yi-Long Wu reports personal financial interests: consulting and advisory services and speaking engagements for Roche, AstraZeneca, Eli Lilly, Boehringer Ingelheim, Sanofi, MSD and BMS. The other authors declare that they have no competing interests.

Ethical approval

The protocol and amendments were all reviewed and approved by the Independent Ethics Committee of each participating center.

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Written informed consent was obtained or waived according to the recommendation of the ethics committee of each participating center for the retrospective study.

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Liu, SY., Chen, Q., Zhou, C. et al. Neoadjuvant Camrelizumab for Non-Small Cell Lung Cancer: A Retrospective Multicenter, Real-World Study (CTONG2004). Cancer Immunol Immunother 72, 2257–2265 (2023). https://doi.org/10.1007/s00262-023-03412-8

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