Camrelizumab-based therapies for the treatment of advanced lung cancer: a prospective, open-label, multicenter, observational, real-world study

Dong Zhao ¹ Minghong Bi ² Xiaofei Cheng ³ Shuhong Wang ⁴ Huaidong Cheng ⁵ Xiaoyang Xia ⁶ Huan Chen ⁷ Yanbei Zhang ⁸ Zhiqiang Hu ⁹ Qisheng Cao ¹⁰ Hui Liang ¹¹ Fan Wang ¹² Xuhong Min ¹³ Ling Xu ¹⁴ Kehai Feng ¹⁵ Jinhua Zhou ¹⁶ Xinzhong Li ¹⁷ Rui Wang ¹⁸ Hua Xie ¹⁹ Xiaosi Chen ²⁰ Kangsheng Gu ^21*

• ¹ Department of Oncology, Lixin County People’s Hospital, Bozhou, China
• ² Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
• ³ Department of Oncology, Anqing Hospital of Navy, Anqing, China
• ⁴ Department of Oncology, Huangshan City People’s Hospital, Huangshan, China
• ⁵ Department of Oncology, Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
• ⁶ Department of Oncology, Chuzhou City First People’s Hospital, Chuzhou, China
• ⁷ Department of Pulmonary and Critical Care Medicine, Anqing Hospital of Navy, Anqing, China
• ⁸ Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
• ⁹ Department of Oncology, Huaibei Miner General Hospital, Huaibei, China
• ¹⁰ Interventional Oncology, Maanshan City People’s Hospital, Maanshan, China
• ¹¹ Department of Radiology, Traditional Chinese Hospital of LuAn, Luan, China
• ¹² Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
• ¹³ Department of Radiology, Anhui Chest Hospital, Hefei, China
• ¹⁴ Department of Pulmonary and Critical Care Medicine, Anhui Chest Hospital, Hefei, China
• ¹⁵ Department of Oncology, The First Affiliated Hospital of USTC West District, Hefei, China
• ¹⁶ Department of Oncology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
• ¹⁷ Department of Oncology, Huaibei City People’s Hospital, Huaibei, China
• ¹⁸ Department of Oncology, Anhui Chest Hospital, Hefei, China
• ¹⁹ Department of Oncology, Xuancheng City People’s Hospital, Xuancheng, China
• ²⁰ Department of Oncology, Dangtu County People’s Hospital, Maanshan, China
• ²¹ Department of Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, China

Objective: Camrelizumab, a programmed death-1 inhibitor, is effective and safe for treating patients with advanced lung cancer according to previous phase 3 trials. However, relevant real-world clinical evidence is required. This study intended to explore the efficacy and safety of camrelizumab-based therapies in patients with advanced lung cancer. Methods: Patients with advanced lung cancer who received camrelizumab-based therapies as first-line or above treatment were consecutively enrolled in this study. The median follow-up duration was 5 months.Results: A total of 298 subjects were enrolled. Objective response rate (ORR) and disease control rate (DCR) were 27.2% and 82.2%. Multivariable logistic regression analysis showed that previous pulmonary surgery [odds ratio (OR)=0.440, P=0.024], previous radiotherapy (OR=0.410, P=0.010), and Eastern Cooperative Oncology Group Performance Status (ECOG PS) score (>1 vs. 0~1) (OR=0.414, P=0.046) were independently and negatively associated with ORR. The median progression-free survival (PFS) [95% confidence interval] was 10.0 (7.8-12.2) months. Median overall survival (OS) was not reached. Multivariable Cox regression analysis suggested that brain metastasis [hazard ratio (HR)=1.548, P=0.036] and liver metastasis (HR=1.733, P=0.035) were independently associated with shorter PFS. Previous chemotherapy (HR=2.376, P=0.022), brain metastasis (HR=2.688, P=0.006), and liver metastasis (HR=2.583, P=0.039) were independently associated with shorter OS. Most adverse events were grade I or II. Grade III and IV adverse events rarely occurred. The occurrence of adverse events was associated with a higher DCR (P=0.003). Conclusions: Camrelizumab-based therapies may serve as potential treatments for patients with advanced lung cancer. However, further studies with an extended follow-up duration are warranted.