The research results of camrelizumab in the field of esophageal cancer - the press conference on the second-line CAP 02 study of advanced esophageal cancer was successfully held!

After immunotherapy has become the standard first- and second-line treatment for advanced esophageal cancer, in order to further improve the efficacy of immunotherapy, new clinical studies are in the ascendant
.

In January 2022, a multi-center phase II clinical study (CAP 02 study) of camrelizumab combined with apatinib in the second-line treatment of advanced esophageal squamous cell carcinoma, led by Prof.
Fan Qingxia and Prof.
Wang Feng from the First Affiliated Hospital of Zhengzhou University.
The results were published in the journal Lancet Gastroenterology & Hepatology (IF: 18.
5)
.

On January 15, the press conference on "Camrelizumab Research Results in the Field of Esophageal Cancer--Second-Line CAP02 Study of Advanced Esophageal Cancer" was successfully held online
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Experts at the meeting interpret the research results and talk about the clinical significance of the research
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Esophageal cancer in China needs Chinese evidence for advanced second-line treatment, and new regimens are urgently needed.
Esophageal cancer is one of the most common malignant tumors in the world, and its morbidity and mortality ranks seventh and sixth among all malignant tumors, respectively
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Prof.
Fan Qingxia said at the meeting that China is one of the regions with the highest incidence of esophageal cancer in the world, and there are great differences between esophageal cancer in China and western countries in terms of pathological type, genetic background, and treatment methods
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The majority of esophageal cancers in China are advanced and metastatic, and the five-year survival rate is less than 5%.
The long-term survival benefit needs to be improved urgently
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The rise and progress of immunotherapy has brought the treatment of esophageal cancer into the fast lane
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In the field of second-line treatment of advanced esophageal cancer, three large RCT studies, ESCORT, KEYNOTE-181 and ATTRACTION-3, confirmed that immune single drug can significantly improve the short-term efficacy and overall survival of advanced esophageal cancer compared with chemotherapy.
Its status in the treatment of esophageal cancer has promoted the approval of related indications
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"Although immunotherapy has achieved unprecedented success, the effective rate of immune monotherapy is only about 20%.
In order to further improve the anti-tumor effective rate, the exploration of combination therapy is in the ascendant
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Among them, anti-angiogenesis combined immunotherapy is the current research.
One of the hot spots
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” Professor Qingxia Fan introduced that anti-angiogenic drugs can inhibit tumor angiogenesis, induce normalization of blood vessels, and enhance immune cell infiltration.
At the same time, anti-angiogenic therapy can also change the tumor microenvironment.
The combination of anti-angiogenic therapy and immunotherapy It can play an anti-tumor effect of 1+1>2.
This mechanism advantage has been verified in tumors such as liver cancer and non-small cell lung cancer
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In this context, Professor Fan Qingxia, the First Affiliated Hospital of Zhengzhou University joined hands with eight hospitals in Henan Province: Anyang Cancer Hospital, the Second Affiliated Hospital of Zhengzhou University, the First Affiliated Hospital of Henan University of Science and Technology, Nanyang Central Hospital, and the First Affiliated to Nanyang Medical College The hospital, Nanyang Second People's Hospital, Xinyang Cancer Hospital, launched a single-arm, open-label, multiple The center's prospective phase II clinical study aims to explore new treatment options with better efficacy for second-line treatment of advanced esophageal cancer
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The CAP 02 study was featured in the Lancet journal.
At the launch of the approval of the carelizumab combined with apatinib regimen, the lead of the CAP 02 study, Professor Wang Feng, introduced the excellent data of the study in detail
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Professor Wang Feng The study included patients with unresectable locally advanced, locally recurrent or metastatic esophageal squamous cell carcinoma who progressed after first-line chemotherapy or were intolerant to first-line chemotherapy
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Treatment regimens consisted of intravenous camrelizumab (200 mg every two weeks) and oral apatinib (250 mg once daily) until disease progression or intolerance
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Results of the study showed that as of June 20, 2021, the median follow-up time was 7.
5 months
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23 of 52 patients achieved objective response (ORR: 44.
2%) and 41 achieved disease control (DCR: 78.
8%); median PFS was 6.
8 months, and progression-free survival at 3 and 6 months were 84.
5% and 55.
3%, respectively; the median OS was 15.
8 months, and the 6-, 9-, and 12-month overall survival rates were 75.
8%, 62.
9%, and 56.
3%, respectively
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Subgroup analysis showed that regardless of PD-L1 expression, patients benefited from the combination of camrelizumab and apatinib
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In terms of safety, the incidence of treatment-related adverse events of grade ≥ 3 was 44%, and the common adverse events of grade ≥ 3 were increased aspartate aminotransferase (10/52, 19%), increased γ-glutamyltransferase.
High (10/52, 19%) and elevated alanine aminotransferase (5/52, 10%)
.

There were no treatment-related deaths
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Prof.
Wang Feng said that whether it is ORR or DCR, the combination of camrelizumab and apatinib far exceeds the efficacy data of previous immune single drug and apatinib single drug, showing the overall efficacy of 1+1>2 The OS data reached 15.
8 months, which has surpassed the data of 15.
3 months of first-line camrelizumab combined with double-drug chemotherapy; its adverse reactions are controllable and manageable, showing the clinical advantages of high efficiency and low toxicity
.

In addition, this study also designed a cohort study of camrelizumab combined with apatinib as a follow-up treatment for patients who failed first-line immune therapy, which is expected to bring new treatment benefits to the immune cross-line population.
The advantages of the anti-angiogenic combined immunization regimen were confirmed
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Second-line treatment of esophageal cancer ushered in new hope CAP 02 study won international reputation Reviewing the development of CAP 02 study, Professor Wang Junsheng of Anyang Cancer Hospital was deeply impressed by the case of a 70-year-old male
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The patient developed distant tumor metastasis one year after the operation.
After being enrolled in the CPA02 study for one course of treatment, the symptoms such as cough and difficulty in eating were significantly relieved, and further relief was achieved after two courses of treatment, and the efficacy evaluation reached PR
.

"According to my nearly 40 years of experience in tumor diagnosis and treatment, for patients with advanced age, poor physical condition, and distant metastatic esophageal cancer like this case, the survival benefit brought by previous traditional treatment is very limited
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The significant effect has given us great confidence, so the enrollment rate of this center is also very fast, and the number of enrolled cases is the largest among the centers
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" Professor Wang Junsheng talked about the significance of the CAP02 study, Professor Wang Junsheng said, Professor Wang Feng et al.
A group of young experts, who dare to innovate and think diligently, creatively combine camrelizumab and low-dose apatinib, which has played a synergistic effect, and has tolerable adverse reactions, which is a treatment for advanced esophageal cancer It has brought new breakthroughs, and has also won the right to speak in the international academic circles of esophageal cancer research in Henan Province, and its influence is far-reaching
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Professor Fan Qingxia believes that the CAP 02 study has brought a new regimen with better efficacy and chemotherapy-free for the second-line treatment of advanced esophageal cancer, enriching the options for the second-line treatment of esophageal cancer, and opening up a path of hope for patients with advanced esophageal cancer
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Camrelizumab has entered Medicare, and its accessibility has also been greatly improved
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"In short, from the perspective of the effectiveness of treatment, the safety of medication, and pharmacoeconomics, the Double Ai regimen has great potential and is expected to become a commonly used regimen for the second-line treatment of esophageal cancer in the future
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" Hengrui Medicine in esophageal cancer In-depth research in the field and far-reaching layout In view of the huge patient population of esophageal cancer in China and the unique disease characteristics, it is of great significance to conduct Chinese research on the Chinese population
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Mr.
Huo Shiwen, deputy general manager of Hengrui Medicine Oncology Division, said that Hengrui Medicine, as a national innovative pharmaceutical company, has a responsibility and a mission to focus on the field of cancer and esophageal cancer with Chinese characteristics
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Along the way, camrelizumab, a domestic PD-1 mAb, has lived up to expectations in the field of esophageal cancer, and its achievements are obvious to all
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Mr.
Huo Shiwen said that from the ESCORT study was included in The Lancet Oncology, the ESCORT-1st study was included in the main journal of JAMA, and today's CAP 02 study was published in The Lancet Gastroenterology and Hepatology Journal, a Chinese force represented by camrelizumab, has received more and more attention from the international academic community in the field of esophageal cancer
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"The achievements represent the past, and the exploration of camrelizumab in the field of esophageal cancer has not stopped
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According to Mr.
Hou Zhiguo, the central medical affairs department of Hengrui Medicine, camrelizumab is used for adjuvant therapy and neoadjuvant therapy of resectable esophageal cancer.
Treatment, perioperative immunotherapy for unresectable locally advanced esophageal cancer and other explorations have been carried out in an all-round way.
It can be said that camrelizumab still has many achievements in the field of esophageal cancer to look forward to
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, not only camrelizumab, but also Hengrui Medicine's subcutaneous injection of PD-1 monoclonal antibody, PARP inhibitor fluzoparib and other original research drugs will launch new explorations in the field of esophageal cancer
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Continue to work hard in the field of esophageal cancer, bring more hope to Chinese patients with esophageal cancer, and bring more good news to patients with esophageal cancer around the world! Click below to learn more about clinical trial projects