Camrelizumab induction and consolidation improved survival in limited-stage SCLC

Background

Definitive chemoradiotherapy followed by immunotherapy consolidation is the current standard of care for limited-stage small cell lung cancer (LS-SCLC)¹. A randomised phase II trial (ChiCTR2000032275) evaluated a camrelizumab-based induction-consolidation strategy in previously untreated patients with LS-SCLC¹.

Study design

Patients were randomly assigned (1:1) to one of two groups¹:

• Camrelizumab group: induction camrelizumab plus etoposide-platinum, followed by concurrent chemoradiotherapy (CRT) and camrelizumab consolidation
• cCRT group: induction chemotherapy followed by concurrent CRT alone

The primary endpoint was the 1-year progression-free survival (PFS) rate. Secondary endpoints included objective response rate (ORR), PFS, overall survival (OS) and safety¹. A total of 41 patients were enrolled between November 2020 and April 2024¹.

Efficacy

At a median follow-up of 32.1 months (interquartile range: 26.4-38.7), ORR was 100% with camrelizumab and 83.3% with cCRT¹. The 1-year PFS rates were 65.5% versus 47.4% (P = 0.029)¹. Median PFS was 24.0 months versus 11.8 months, and median OS was not reached versus 23.9 months (P = 0.042)¹.

Exploratory biomarkers

Patients with neutrophil-to-lymphocyte ratio <2.8 or platelet-to-lymphocyte ratio <207.0 at baseline, and those with a decline in lactate dehydrogenase at week 12 after CRT, derived greater benefit from camrelizumab¹. The OS benefit was more evident in patients with Ki-67 ≤80%¹.

Safety

Toxicities with camrelizumab were manageable, with severe immune-related adverse events in 4.8%. Radiation pneumonitis rates were comparable between groups¹.

Conclusion

The authors state that the strategy warrants further validation¹.