Camrelizumab plus chemo combo beneficial in Asian patients with advanced NSCLC

Adding camrelizumab to platinum-based chemotherapy in the neoadjuvant treatment setting appears to improve the rate of pathologic complete response (pCR) in Asian patients with stage IIIA or IIIB non–small cell lung cancer (NSCLC), with manageable toxicity, according to data from the phase II TD-FOREKNOW study.

TD-FOREKNOW included 94 adult patients in China who had resectable stage IIIA or IIIB NSCLC. These patients were randomly assigned to receive three cycles of camrelizumab (200 mg) plus chemotherapy (nab-paclitaxel, 130 mg/m2, and platinum [cisplatin, 75 mg/m2; carboplatin, area under the curve, 5; or nedaplatin, 100 mg/m2]) or chemotherapy alone, followed by surgery after 4 to 6 weeks.

Of the patients, 88 (93.6 percent, median age 61 years, 84.1 percent men) received the allocated neoadjuvant treatment, with 43 receiving camrelizumab plus chemotherapy and 45 receiving chemotherapy alone).

The primary endpoint of pCR rate was significantly higher in the camrelizumab-chemo group than in the chemo-alone group (32.6 percent, 95 percent confidence interval [CI], 19.1–48.5 vs 8.9 percent, 95 percent CI, 2.5–21.2; odds ratio, 4.95, 95 percent CI, 1.35–22.37; p=0.008).

Secondary endpoints were also more favourable in the camrelizumab-chemo group than in the chemo-alone group. Specifically, the major pathologic response rates were 65.1 percent and 15.6 percent, and the radiographic objective response rates were 72.1 percent and 53.3 percent, respectively.

Over a median follow-up of 14.1 months, the event-free survival (EFS) and disease-free survival were not reached in either group.

In terms of safety, the most frequent neoadjuvant treatment-related adverse events of grade 3 or higher included decreased white blood cell count (14.0 percent with camrelizumab plus chemotherapy and 4.4 percent with chemotherapy alone) and decreased neutrophil count (7.0 percent and 11.1 percent, respectively). There were no treatment-related deaths reported.