Camrelizumab–apatinib combo beneficial in advanced hepatocellular carcinoma

The combination of camrelizumab, an antiprogrammed death (PD-1) monoclonal antibody, plus apatinib, a VEGFR-2 tyrosine kinase inhibitor (TKI), shows promise in the first- and second-line treatment of patients with advanced hepatocellular carcinoma (HCC), conferring survival benefits with manageable safety profile, according to the results of the phase II RESCUE trial.

RESCUE included patients with advanced HCC who were treatment-naïve or refractory/intolerant to first-line targeted therapy. Patients were given intravenous camrelizumab at 200 mg (for bodyweight ≥50 kg) or 3 mg/kg (for bodyweight <50 kg) every 2 weeks in addition to oral apatinib 250 mg daily.

In total, 70 patients were treated in the first-line setting and 120 patients in the second-line setting. The median follow-up was 16.7 and 14.0 months in the respective cohorts.

The objective response rate was 34.3 percent (24/70; 95 percent confidence interval (CI), 23.3–46.6) in the first-line cohort and 22.5 percent (27/120; 95 percent CI, 15.4–31.0) in the second-line cohort. Median progression-free survival rates were 5.7 months (95 percent CI, 5.4–7.4) and 5.5 months (95 percent CI, 3.7–5.6), and the 12-month survival rates were 74.7 percent (95 percent CI, 62.5–83.5) and 68.2 percent (95% CI, 59.0–75.7), respectively.

Most patients (77.4 percent) developed grade ≥3 treatment-related adverse events (TRAE), with the most common being hypertension (34.2 percent). Serious TRAEs were documented in 55 patients (28.9 percent). There were two (1.1 percent) treatment-related deaths.

The present data suggest that the camrelizumab–apatinib combination might represent a novel treatment option for patients with advanced HCC.