scholarly journals O-15 Randomized, phase 3 study of second-line tislelizumab vs chemotherapy in advanced or metastatic esophageal squamous cell carcinoma (RATIONALE 302) in the overall population and Europe/North America subgroup

2021 ◽  
Vol 32 ◽  
pp. S225
Author(s):  
J. Ajani ◽  
F. El Hajbi ◽  
D. Cunningham ◽  
M. Alsina ◽  
P. Thuss-Patience ◽  
...  
2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Feng Wang ◽  
Qingxia Fan ◽  
Junsheng Wang ◽  
Tao Wu ◽  
Yonggui Hong ◽  
...  

Abstract   Esophageal squamous cell carcinoma (ESCC) as a common malignancy is prevalent in East Asia and in eastern and southern Africa. Although pembrolizumab, nivolumab and camrelizumab are respectively recommended as second-line treatment for advanced ESCC due to improved overall survival (OS), objective response rate (ORR) was modest. New effective treatments are needed. Hence, the study of camrelizumab plus apatinib (VEGFR2 inhibitor) as second-line treatment for advanced ESCC was performed. Methods This ongoing phase II trial (NCT03736863) in six sites in China enrolled pts aged 18-75 with unresectable locally advanced, locally recurrent, or metastatic ESCC that progressed or were intolerant after first-line chemotherapy, and an ECOG performance status of 0-1. Pts received 200 mg camrelizumab intravenously every 2 weeks and apatinib 250 mg orally once per day in 4-week cycles until disease progression, unacceptable adverse events (AEs) or withdrawal of consent. The primary endpoint was investigator-assessed ORR. Secondary endpoints included disease control rate (DCR), progression-free survival (PFS) and OS. Results At data cutoff (Feb 28, 2021), 52 pts were enrolled, including 42 males and 50 with distant metastases, with the median age of 62 years. In the evaluable population of 39 pts, ORR without confirmation was 43.59% and DCR was 94.87%. The median duration of response was 6.9 months (95% CI 4.57–9.23). The median PFS was 6.8 month (95% CI 2.66–10.94). The 12-month overall survival was 52.2%. A total of 80.8% of pts had treatment-related AEs (TRAEs) with 46.2% of grade ≥ 3 TRAEs. The safety profile of camrelizumab and apatinib was consistent with other anti–PD-1 antibodies and angiogenesis inhibitors. Conclusion This is the first study that evaluates the combination anti–PD-1 antibody and anti-angiogenesis inhibitor as a second-line therapy for advanced ESCC. Camrelizumab plus apatinib showed encouraging clinical efficacy and acceptable safety. Further phase III randomized trials are warranted.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS4147-TPS4147
Author(s):  
Feng Wang ◽  
Xiangrui Meng ◽  
Qingxia Fan

TPS4147 Background: Approximately 40% of patients (pts) with esophageal cancer are diagnosed with advanced unresectable or metastatic disease; the 5-year survival rate for advanced disease is 5%. No standard therapy is available in China for Advanced Esophageal Squamous Cell Carcinoma(ESCC) patients progressed after first-line chemotherapy.Inhibition of programmed cell death protein-1 (PD-1) has demonstrated promising antitumor activity and manageable safety in pts with advanced unresectable or metastatic ESCC. SHR-1210, a humanized IgG4 monoclonal antibody, has high affinity and specificity for PD-1 molecule. SHR-1210 was generally well tolerated and had preliminary antitumor effects in pts with solid tumors, including ESCC. Nimotuzumab, a humanized anti-epidermal growth factor receptor monoclonal antibody h-R3, has been shown to be effective and safe in the treatment of head and neck cancer,non-small cell lung cancer (NSCLC) and esophageal Cancer in several phase II studies.The purpose of this study is to observe and evaluate the efficacy and safety of anti-PD-1 antibody SHR-1210 combined with nimotuzumab as second-line therapy in patients with advanced ESCC. Methods: Patients, age 18-75, with measurable tumor lesion, failed in or progression after 1st line chemotherapy, were enrolled in this study.Patients received SHR-1210 200 mg once every 2 weeks (Q2W) combined nimotuzumab 200 mg weekly until disease progression, death or unacceptable toxicity.Assessments included response by RECIST v1.1 every 6 wks and safety (physical examination, vital signs, ECOG PS, laboratory tests).The primary endpoint is the objective response rate (ORR),and the secondary end points include the diseases control rate (DCR),duration of response (DOR),progression-free survival (PFS),and overall survival(OS). Additionally, we try to identify biomarker to predict efficacy of SHR-1210 and Nimotuzumab with target capture sequencing and gene expression profile as exploratory endpoints. Clinical trial information: NCT03766178.


2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 179-179
Author(s):  
Hayato Mikuni ◽  
Shun Yamamoto ◽  
Kotoe Oshima ◽  
Hidekazu Hirano ◽  
Natsuko Okita ◽  
...  

179 Background: Based on the results of the ATTRACTION-1 and ATTRACTION-3 trials, nivolumab monotherapy has used for the treatment of metastatic or recurrence esophageal cancer patients who were refractory or intolerant to fluoropyrimidine and platinum since February 2020 in Japan. However, the ATTRACTION-1 trial mainly included patients who received nivolumab monotherapy as third or later-line treatments, which was different from the ATTRACTION-3 trial which mainly included patients as second-line treatment. Therefore, it is still unclear whether the treatment lines affect the efficacy of nivolumab in clinical practice. Methods: Medical records were retrospectively reviewed for patients diagnosed with metastatic or recurrence esophageal squamous cell carcinoma (ESCC) who received nivolumab monotherapy as second- or third or later-line treatments in our hospital. We evaluated progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR) based on the RECIST ver1.1, and the incidences of adverse events (AEs) based on the CTCAE ver5.0. Results: Sixty-two patients were identified as the subject of this study. Thirty patients received nivolumab as second-line treatment (48.4%) and 32 patients as third or later-line treatments (51.6%). The median age (range) were 67 (33-80)/61 (52-84), PS 0 were 40.0/21.9%, prior taxane treatment rate were 6.7/93.8%, respectively. The ORR/DCR were 22.7/45.5% in second-line treatment, and 24.1/44.8% in third or later-line treatments (p=1.00). The median PFS (95% CI) was 2.3 (1.4-6.2)/2.3 (1.2-3.6) months in the second-/third or later-line treatments (HR=0.86, p=0.58). AEs of grade 3 or higher were observed in 6.7/6.3% of the second-/third or later-line treatments. Conclusions: There was no clear difference between second -line and third or later-line treatments in the short-term efficacy of nivolumab monotherapy in advanced ESCC patients.


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