Adding Camrelizumab to Chemo Improves OS in Advanced Squamous NSCLC

Adding camrelizumab to chemotherapy provides an overall survival (OS) benefit in patients with advanced squamous non-small cell lung cancer (NSCLC), according to updated results from the phase 3 CameL-sq trial.¹

The findings were presented at the 2022 European Lung Cancer Congress (ELCC) by Caicun Zhou, MD, PhD, of Shanghai Pulmonary Hospital in China.

The phase 3 CameL-sq trial (ClinicalTrials.gov Identifier: NCT03668496) included 390 patients with stage IIIB-IV squamous NSCLC who had no prior systemic treatment. 

Patients were randomly assigned to receive 4-6 cycles of carboplatin plus paclitaxel with camrelizumab (n=193) or placebo (n=197) every 3 weeks, followed by maintenance with camrelizumab or placebo for up to 2 years. 

Patients in the placebo arm could cross over to receive camrelizumab after disease progression. Baseline characteristics between the 2 arms were well balanced. 

At the primary analysis, the median progression-free survival was significantly longer with camrelizumab than with placebo — 8.5 months and 4.9 months, respectively (hazard ratio [HR], 0.37; 95% CI, 0.29-0.47; P <.0001).² However, the OS data were not mature at that time. 

For the current analysis,² the median follow-up was 23.7 months for the camrelizumab arm and 15.2 months for the placebo arm. 

The median OS was 27.4 months in the camrelizumab arm and 15.5 months in the placebo arm (HR, 0.57; 95% CI, 0.44-0.74; P <.0001). The 2-year OS rate was 53.4% in the camrelizumab arm and 35.0% in the placebo arm. The 3-year OS was 42.8% and 23.7%, respectively.

The crossover-adjusted median OS was 27.4 months in the camrelizumab arm and 12.4 months in the placebo arm (HR, 0.41; 95% CI, 0.30-0.56; P <.0001). Approximately 56% of patients in the placebo arm crossed over to receive camrelizumab.  

No new safety signals were reported. Treatment-related adverse events (AEs) occurred in 100% of patients in the camrelizumab arm and 99.5% of patients in the placebo arm. The rate of grade 3/4 treatment-related AEs was 74.1% and 71.4%, respectively.

The rate of immune-related AEs was 77.2% in the camrelizumab arm and 20.4% in the placebo arm. Treatment-related deaths occurred in 6 patients in the camrelizumab arm and 3 in the placebo arm.

“These data further support camrelizumab plus chemo as a standard first-line treatment option for advanced squamous NSCLC,” Dr Zhou concluded.

Disclosures: This research was supported by Jiangsu Hengrui Pharmaceuticals Co., Ltd. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

References

1. Zhou C, Cheng Y, Chen J, et al. First-line camrelizumab plus carboplatin and paclitaxel for advanced squamous non-small-cell lung cancer: Updated overall survival results from the phase 3 CameL-sq trial. Presented at ELCC 2022; March 30 – April 2, 2022. Abstract 3MO. 
2. Ren S, Chen J, Xu X, et al. Camrelizumab plus carboplatin and paclitaxel as first-line treatment for advanced squamous NSCLC (CameL-sq): A phase 3 trial. J Thorac Oncol. 2022;17(4):544-557. doi:10.1016/j.jtho.2021.11.018 

This article originally appeared on Cancer Therapy Advisor