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Qu W, Wang F, Qin S, Sun Y, Huang C. Reactive cutaneous capillary endothelial proliferation following camrelizumab monotherapy or combination therapy for multi-cancers: a large-scale pooled analysis of 10 studies in China. Ther Adv Med Oncol 2024; 16:17588359241242607. [PMID: 38606164 PMCID: PMC11008344 DOI: 10.1177/17588359241242607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Background Skin toxicities are the most common adverse events related to immunotherapy, such as reactive cutaneous capillary endothelial proliferation (RCCEP) following treatment with the anti-programmed cell death-1 antibody camrelizumab. Objective This study aimed to comprehensively analyze the clinical features and prognostic value of RCCEP in patients with malignancies who received camrelizumab alone (Camre) or in combination with the angiogenesis-targeted agent apatinib (Camre-Apa) or chemotherapy (Camre-Chemo). Design A large-scale pooled analysis. Methods Individual patient-level data were derived from 10 clinical trials of camrelizumab monotherapy, camrelizumab plus apatinib, or camrelizumab plus chemotherapy (n = 1305). Results RCCEP occurred in 77.0% (516/670) of patients with Camre, 23.6% (70/296) with Camre-Apa, and 67.8% (230/339) with Camre-Chemo. Most RCCEP lesions were grade 1 or 2 in severity. The median time to onset was 0.8 months [interquartile range (IQR), 0.6-1.2] with Camre, 5.0 months (IQR, 2.7-8.0) with Camre-Apa, and 1.6 months (IQR, 1.0-4.2) with Camre-Chemo; and the median duration was 4.8 months (IQR, 2.6-8.8), 4.4 months (IQR, 1.7-8.9), and 7.2 months (IQR, 4.1-14.3), respectively. In all the three groups, patients with RCCEP showed significantly better clinical outcomes compared with those without [objective response rate: 23.8% versus 1.9% with Camre, 48.6% versus 21.2% with Camre-Apa, and 78.7% versus 54.1% with Camre-Chemo; median progression-free survival: 3.2 versus 1.7 months (hazard ratio (HR) = 0.36), 10.2 versus 4.5 months (HR = 0.39), and 12.7 versus 7.3 months (HR = 0.38); median overall survival: 13.3 versus 3.8 months (HR = 0.34), 29.2 versus 13.5 months (HR = 0.46), and not reached versus 12.8 months (HR = 0.19); all p < 0.0001]. Conclusion Although RCCEP occurred frequently with camrelizumab, most lesions were mild and self-limiting. The occurrence of RCCEP was strongly associated with the antitumor activity and survival of camrelizumab, both as monotherapy and in combination therapy.
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Affiliation(s)
- Wenshu Qu
- Department of Medical Oncology, Affiliated Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, China
| | - Feng Wang
- Department of Medical Oncology, Affiliated Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shukui Qin
- Department of Medical Oncology, Affiliated Jinling Hospital, Nanjing University of Chinese Medicine, No. 34, 34 Biao, Yanggongjing Street, Nanjing 210002, China
| | - Yuqi Sun
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Chuanpei Huang
- Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
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Lin Y, Lin Y, Zhong X, Chen Q, Tang S, Chen J. A case report and literature review on reactive cutaneous capillary endothelial proliferation induced by camrelizumab in a nasopharyngeal carcinoma patient. Front Oncol 2023; 13:1280208. [PMID: 38090483 PMCID: PMC10715407 DOI: 10.3389/fonc.2023.1280208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/08/2023] [Indexed: 02/29/2024] Open
Abstract
Camrelizumab, a monoclonal antibody, blocks programmed cell death protein-1 from binding to T cells and programmed cell death ligand 1 on tumor cells, thereby ensuring sustained T cell activation and blocking immune escape of various types of cancer, including nasopharyngeal carcinoma. Reactive cutaneous capillary endothelial hyperplasia (RCCEP) is the most common immune-related adverse event in patients treated with camrelizumab. We report a case nasopharyngeal carcinoma in a patient with camrelizumab-induced RCCEP. A 68-year-old man diagnosed with nasopharyngeal carcinoma developed RCCEP at multiple locations after 3 months of camrelizumab treatment. RCCEP of the right lower eyelid affected closure of the right eye. In this report, we also reviewed previous literature on camrelizumab-induced RCCEP. In summary, the mechanism underlying camrelizumab-induced RCCEP remains unclear. RCCEP typically gradually subsides after discontinuing camrelizumab treatment. Larger nodules can be treated with lasers, ligation, or surgery. Although surgical excision is effective, RCCEP may recur in patients undergoing camrelizumab treatment. RCCEP management may not be required in the absence of adverse effects on the patient's daily life.
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Affiliation(s)
| | | | | | | | | | - Jiasheng Chen
- Department of Plastic Surgery and Burn Center, Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
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Liu Y, Liu H, Bian Q, Guan Y. A 67-Year-Old Man with Grade 3 Reactive Cutaneous Capillary Endothelial Proliferation Induced by Camrelizumab First Manifested in the Oral Mucosa - A Case Report. Int J Surg Pathol 2023:10668969231195032. [PMID: 37723943 DOI: 10.1177/10668969231195032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Reactive cutaneous capillary endothelial proliferation (RCCEP) is the most common immune-related adverse event induced by camrelizumab (SHR-1210). Very rare cases have been reported in oral tissues, especially the oral mucosa. We reported a 67-year-old male with Grade 3 RCCEP. Multiple dome-shaped and bright red papules were first observed in the oral mucosa, which gradually developed on his lip, face, scalp, neck, foot, calf, abdomen and groin. The patient's symptoms gradually improved at 4 weeks after SHR-1210 discontinuation and were mostly relieved at 7 weeks after discontinuation. Our findings revealed that oral examination should be performed regularly during SHR-1210 treatment.
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Affiliation(s)
- Yong Liu
- Department of Dermatology & STD, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin, China
| | - Hui Liu
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
| | - Queqiao Bian
- Department of Dermatology & STD, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin, China
| | - Yanmin Guan
- Department of Tuberculosis, Tianjin Haihe Hospital, Tianjin, China
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Wang C, Lei K, Jia Y, Jiang Z, Wang S. Complete remission of reactive cutaneous capillary endothelial proliferation caused by the programmed cell death-1 inhibitor camrelizumab achieved through thalidomide monotherapy: A case report. Exp Ther Med 2023; 26:324. [PMID: 37346410 PMCID: PMC10280312 DOI: 10.3892/etm.2023.12023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/25/2023] [Indexed: 06/23/2023] Open
Abstract
Reactive cutaneous capillary endothelial proliferation (RCCEP) is a common adverse effect of the anti-programmed cell death-1 (PD-1) monoclonal antibody camrelizumab and usually occurs on the skin. This condition causes bleeding nodules of varying severity depending on disease grade; these affect a person's appearance and quality of life. The exact mechanism remains elusive and its occurrence in visceral organs has not been previously reported, to the best of our knowledge. Furthermore, there is currently a lack of standard, uniform treatments. The present study reported on a patient who experienced RCCEP during treatment with camrelizumab and benefited greatly from thalidomide, which caused no serious adverse events. An elderly Chinese female initially diagnosed with stage II endometrial cancer had previously undergone surgery, radiotherapy and intravenous chemotherapy but developed multiple metastases in the peritoneum and vaginal remnant. The patient was subsequently prescribed camrelizumab after systemic treatment failed. Soon after commencing treatment with this PD-1 inhibitor, the patient developed RCCEP, whereupon oral low-dose thalidomide monotherapy (100 mg nightly) was prescribed. At two weeks after commencing thalidomide, the RCCEP symptoms were alleviated. Based on this patient's successful treatment, it is suggested that low-dose thalidomide may be an alternative intervention for patients with camrelizumab-induced RCCEP.
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Affiliation(s)
- Chunxiu Wang
- Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China
| | - Kaijian Lei
- Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China
| | - Yuming Jia
- Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China
| | - Zuxin Jiang
- Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China
| | - Shanbing Wang
- Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China
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Fu S, Li C, Wang Z, Zhong Z, Zhong Y. A case report of thalidomide in the treatment of camrelizumab-induced reactive cutaneous capillary hyperplasia. Medicine (Baltimore) 2023; 102:e34120. [PMID: 37390264 PMCID: PMC10313310 DOI: 10.1097/md.0000000000034120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/07/2023] [Indexed: 07/02/2023] Open
Abstract
RATIONALE Reactive cutaneous capillary endothelial proliferation (RCCEP) is the most prevalent immune-related adverse event observed in patients undergoing camrelizumab treatment, and there is a lack of effective therapeutic strategies. Thalidomide (THD) has anti-inflammatory, immunomodulatory, antiangiogenic, and antitumor properties, which have led to its use in various autoimmune diseases, hematological malignancies, solid tumors, and other disorders. PATIENT CONCERNS A 52-year-old male patient with lung cancer developed vascular moles on his face, neck, and back after 3 cycles of chemotherapy comprising pemetrexed and carboplatin combined with camrelizumab immunotherapy. The moles ranged in size (0.1-1.2 cm) and were red or red-black, appearing on the skin's surface. The patient was advised to avoid scratching or friction, continue monitoring, and apply Yunnan Baiyao powder if a papule ruptured. After the third treatment cycle, papules on the patient's face, particularly an eyelid vascular mole, ulcerated, causing significant psychological distress. DIAGNOSIS RCCEP induced by camrelizumab was considered. INTERVENTIONS The patient received 50 mg of THD in the morning and 100 mg in the evening. OUTCOMES The vascular nevus began to shrivel after 1 week and started disappearing after 2 weeks of THD treatment. After 3 THD treatment courses, RCCEP was alleviated without recurrence, allowing the patient to successfully complete camrelizumab treatment. LESSONS During treatment with camrelizumab, if a patient develops moderate or severe RCCEP, and local therapy or anti-infective therapies prove insufficient, THD may be considered as a potential treatment option to improve RCCEP symptoms.
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Affiliation(s)
- Shujuan Fu
- Oncology Department, Shanghai TCM-Intergrated Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Cunya Li
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiying Wang
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhixian Zhong
- East Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Yi Zhong
- Oncology Department, Shanghai TCM-Intergrated Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Hui-Mei P, Guang-Ming H, Xiao-Ling Q, Hong-Liang Z, Si-Jun W. Reactive Cutaneous Capillary Endothelial Proliferation Caused by Camrelizumab: Sixteen Case Reports. Indian J Dermatol 2023; 68:318-326. [PMID: 37529461 PMCID: PMC10389131 DOI: 10.4103/ijd.ijd_343_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
To investigate the regularity and characteristics of adverse drug reaction (ADR) of reactive cutaneous capillary endothelial proliferation caused by Camrelizumab, so as to provide reference for clinical rational use of drugs. Searching for case reports of Camrelizumab-induced reactive cutaneous capillary endothelial proliferation (RCCEP) in databases such as China Biology Medicine disc, VIP Database, CNKI, Wanfang Medical, PubMed, Wiley online library, Embase with "Carritzumab/Ericab," "SHR-1210," "Reactive cutaneous capillary endothelial proliferation," "Reactive capillary hemangiomas," and "Capillary proliferation" as search terms. The retrieval time is from the establishment of the database to February 2022. After eliminating clinical trials and incomplete literature, information of patients included in the literature was analyzed, which included gender, age, reason for medication, usage and dosage, time of ADR, concomitant medication, clinical manifestations, intervention measures, outcomes of patients, etc. A total of 11 articles involving 16 patients were included, including 11 males and five females, with an average age of 60.5 years. Reasons for medication included nine cases of non-small cell lung cancer (NSCLC), four cases of liver cancer, one case of small cell lung cancer (SCLC), one case of synovial sarcoma, and one case of Hodgkin lymphoma. Thirteen patients recorded in detail that the dosage of Camrelizumab was 200 mg, and the frequency of medication was q2w~q4w. Eight patients were treated with Camrelizumab alone, and eight patients were treated with combined medication. RCCEP occurred in nine patients after the first medication, and in seven patients after two-four cycles of medication, the average medication cycle was two cycles, and the average occurrence time was 12.5 days after the last medication. The main clinical manifestations were that several different sizes of growths such as red nevus-like, pearl-like, and mulberry-like growths appear on the head, face, neck, torso, limbs, and other parts of the body, all of which were grade 1-2. The RCCEP of all patients was controlled after treatment. During the treatment, 11 patients were stable and five patients were local remission. RCCEP is caused by Camrelizumabis a special skin immune response, which will not cause life-threatening to patients. However, clinicians and pharmacists should be familiar with the characteristics and regularities of the adverse reaction, to do a good job in medication monitoring and management, as for ensuring the safety of patients with medication.
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Affiliation(s)
- Pang Hui-Mei
- From the Department of Pharmacy, Guangxi International Zhuang Medical Hospital, Nanning, Guangxi, China
| | - Huang Guang-Ming
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qin Xiao-Ling
- From the Department of Pharmacy, Guangxi International Zhuang Medical Hospital, Nanning, Guangxi, China
| | - Zhang Hong-Liang
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wei Si-Jun
- From the Department of Pharmacy, Guangxi International Zhuang Medical Hospital, Nanning, Guangxi, China
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Wang J, Li S, Zhang L, Zhang X. A combination of anti-PD-1 therapy and apatinib successfully treated a patient with EGFR mutation-negative advanced lung adenocarcinoma: A case report. J Cancer Res Ther 2023; 19:141-143. [PMID: 37006054 DOI: 10.4103/jcrt.jcrt_1710_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Here, we report the case of a patient with advanced lung adenocarcinoma with negative driver genes, who benefited from treatment with anti-programmed cell death-1 (anti-PD-1) therapy combined with a low dose of apatinib. From February 2020, the patient was treated with camrelizumab combined with pemetrexed disodium. The treatment regimen was adjusted to camrelizumab combined with a low dose of apatinib every 3 weeks because the patient could not tolerate the side effects of the previous chemotherapy, and camrelizumab led to reactive cutaneous capillary endothelial proliferation (RCCEP). After six cycles of camrelizumab plus a low dose of apatinib, the curative effect achieved was complete response (CR), with milder symptoms of RCCEP than before. Until the follow-up time of March 2021, the efficacy evaluation reached CR and the symptoms of RCCEP disappeared. This case report provides a theoretical basis for camrelizumab combined with a low dose of apatinib for the treatment ofcarcinoma patients with advanced lung adenocarcinoma with negative driver genes.
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Affiliation(s)
- Jian Wang
- Department of Minimally Invasive Surgery, The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), 38 Wuyingshan Road, Tianqiao District, Jinan, Shandong Province, China
| | - Shancheng Li
- Department of Minimally Invasive Surgery, The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), 38 Wuyingshan Road, Tianqiao District, Jinan, Shandong Province, China
| | - Lei Zhang
- Department of Wise Information Technology of Med, Shandong Provincial Third Hospital, 12 Wuyingshan Road, Tianqiao District, Jinan, Shandong Province, China
| | - Xikun Zhang
- Department of Minimally Invasive Surgery, The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), 38 Wuyingshan Road, Tianqiao District, Jinan, Shandong Province, China
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Dang YC, Liu HB, Wang Z, Zhou YL, Chen J, Kong QT, Sang H. Cutaneous adverse events associated with PD-1 inhibitor-based therapy in patients with non-small-cell lung cancer. Future Oncol 2022; 18:3853-3861. [PMID: 36519587 DOI: 10.2217/fon-2022-0888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim: To analyze the incidence and characteristics of cutaneous adverse events (CAEs) in non-small-cell lung cancer patients treated with PD-1 inhibitor-based therapy. Methods: A total of 150 non-small-cell lung cancer patients under PD-1 inhibitor-based therapy from February 2018 to September 2021 were included and were followed up with regularly. Results: Over one-half of patients (88/150; 58.7%) had CAEs. Reactive cutaneous capillary endothelial proliferation, maculopapular rash and pruritus were the most common CAEs. The incidences of CAEs were 50.0 (18/36), 67.0 (50/75) and 51.3% (20/39) with PD-1 inhibitor monotherapy, PD-1 inhibitor in combination with chemotherapy and PD-1 inhibitor in combination with antivascular/targeted therapy, respectively. Conclusion: CAEs occur frequently in PD-1 inhibitor-based therapy but are generally tolerable.
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Affiliation(s)
- Yong-Chao Dang
- Department of Dermatology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, PR China
| | - Hong-Bing Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, PR China
| | - Zhen Wang
- Department of Radiation Oncology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, PR China
| | - Yu-Lin Zhou
- Department of Urology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, PR China
| | - Jun Chen
- Department of Dermatology, Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, 210031, PR China
| | - Qing-Tao Kong
- Department of Dermatology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, PR China
| | - Hong Sang
- Department of Dermatology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, PR China
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Song G, Zhang FF, Cheng HD. Thalidomide for prevention of camrelizumab-induced reactive cutaneous capillary endothelial proliferation. Australas J Dermatol 2022; 63:217-221. [PMID: 35229882 PMCID: PMC9313837 DOI: 10.1111/ajd.13812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 01/10/2023]
Abstract
Objectives The study evaluated the efficacy of thalidomide in prevention of camrelizumab‐induced reactive cutaneous capillary endothelial proliferation (RCCEP). Methods In this study, patients treated with camrelizumab plus thalidomide or camrelizumab alone were included. The occurrences, onset time, severity of RCCEP and the adverse effect of thalidomide were analysed. Results A total of 19 patients were enrolled. The incidence of RCCEP in thalidomide group (2/9, 22.2%) was significantly lower than that in camrelizumab group (8/10, 80%). The median onset time of RCCEP was 5 weeks and 4 weeks respectively. The adverse events of thalidomide were mild, and no treatment‐associated interruption was observed. Conclusions Thalidomide showed a promising in prevention of the RCCEP in patients receiving camrelizumab therapy with an acceptable safety profile.
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Affiliation(s)
- Geng Song
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Fei-Fei Zhang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huai-Dong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Lickliter JD, Gan HK, Voskoboynik M, Arulananda S, Gao B, Nagrial A, Grimison P, Harrison M, Zou J, Zhang L, Luo S, Lahn M, Kallender H, Mannucci A, Somma C, Woods K, Behren A, Fernandez-Penas P, Millward M, Meniawy T. A First-in-Human Dose Finding Study of Camrelizumab in Patients with Advanced or Metastatic Cancer in Australia. Drug Des Devel Ther 2020; 14:1177-1189. [PMID: 32256049 PMCID: PMC7090185 DOI: 10.2147/dddt.s243787] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/20/2020] [Indexed: 12/18/2022]
Abstract
Purpose Camrelizumab inhibits PD-1 in non-clinical models and showed typical non-clinical pharmacokinetic (PK) and safety profiles for an IgG4 monoclonal antibody. We report results from the First-in-Human Phase 1 trial of camrelizumab in Australian population. Methods Camrelizumab was administered to patients with advanced solid tumors who had failed standard therapies. In the dose-escalation phase (n=23), camrelizumab was administered intravenously at 1 mg/kg, 3 mg/kg, 6 mg/kg, and 10 mg/kg every 2 weeks. In dose expansion (n=26), camrelizumab was given at 200 mg or 600 mg every 4 weeks. Results Two dose-limiting toxicities were observed during dose escalation: transaminase elevation and diarrhea (both grade 3). Overall, treatment-related adverse events were consistent with the expected toxicity profile of immune checkpoint inhibition, with the striking exception of the dose-related development of angiomatous skin lesions characterized as reactive cutaneous capillary endothelial proliferation. The PK profile showed a dose-progressive increase in half-life from 3 days at 1 mg/kg to 7 days at 10 mg/kg. Moreover, receptor occupancy assays showed a PD-1 occupancy of >50% in most patients out to 28 days post-dose. The objective response rate was 15.2% (95% CI 6.3–28.9). Conclusion Camrelizumab has manageable toxicity and encouraging preliminary antitumor activity in advanced solid tumors in Australia. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT02492789.
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Affiliation(s)
| | - Hui K Gan
- Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia.,Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Melbourne, Victoria, Australia.,Department of Medical Oncology, La Trobe University School of Cancer Medicine, Bundoora, Victoria, Australia
| | - Mark Voskoboynik
- Nucleus Network, Melbourne, Victoria, Australia.,Department of Medical Oncology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Medical Oncology, Monash University, Central Clinical School, Alfred Campus, Melbourne, Victoria, Australia
| | - Surein Arulananda
- Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia.,Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Melbourne, Victoria, Australia.,Department of Medical Oncology, La Trobe University School of Cancer Medicine, Bundoora, Victoria, Australia
| | - Bo Gao
- Blacktown Cancer and Haematology Centre, Blacktown Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Adnan Nagrial
- Blacktown Cancer and Haematology Centre, Blacktown Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Peter Grimison
- Department of Medical Oncology, Chris O'Brien Life House, Camperdown, New South Wales, Australia
| | - Michelle Harrison
- Department of Medical Oncology, Chris O'Brien Life House, Camperdown, New South Wales, Australia
| | - Jianjun Zou
- Jiangsu Hengrui Medicine Co. Ltd, Shanghai, People's Republic of China
| | - Lianshan Zhang
- Jiangsu Hengrui Medicine Co. Ltd, Shanghai, People's Republic of China
| | - Stacey Luo
- Jiangsu Hengrui Medicine Co. Ltd, Shanghai, People's Republic of China
| | - Michael Lahn
- Incyte Biosciences International Sarl, Geneva, Switzerland
| | | | | | - Catello Somma
- Incyte Biosciences International Sarl, Geneva, Switzerland
| | - Katherine Woods
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Melbourne, Victoria, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Melbourne, Victoria, Australia.,Department of Medical Oncology, La Trobe University School of Cancer Medicine, Bundoora, Victoria, Australia
| | - Pablo Fernandez-Penas
- Department of Dermatology, The University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
| | - Michael Millward
- Linear Clinical Research, Nedlands, Western Australia, Australia
| | - Tarek Meniawy
- Linear Clinical Research, Nedlands, Western Australia, Australia
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