CamreliZumab Plus Carboplatin and PemetreXed as First-Line Treatment for Advanced NonsQuamous NSCLC: EXtended Follow-Up of CameL Phase 3 Trial

Introduction: In CameL phase 3 study (ClinicalTrials.gov: NCT03134872), addition of camrelizumab to first-line chemotherapy significantly improved the progression-free survival in patients with stages IIIB to IV nonsquamous NSCLC. Here, we present outcomes after a minimum followup of 43.9 months since last patient randomization.Methods: Eligible patients were randomized 1:1 to 4 to 6 cycles of camrelizumab plus carboplatin and pemetrexed or chemotherapy alone every 3 weeks, followed by maintenance camrelizumab plus pemetrexed or pemetrexed only (n = 205 and 207, respectively). Total camrelizumab exposure was up to 2 years.Results: As of January 31, 2022, camrelizumab plus chemotherapy exhibited substantially improved overall survival over chemotherapy alone (median, 27.1 versus 19.8 mo; hazard ratio = 0.72 [95% confidence interval: 0.57-0.92]). In the chemotherapy-alone group, 95 patients (45.9%) crossed over to camrelizumab monotherapy. After adjustment for crossover, the survival benefit with camre-lizumab plus chemotherapy was more pronounced (adjusted hazard ratio = 0.55 [95% confidence interval: 0.42-0.71]). In camrelizumab plus chemotherapy group, 33 patients completed 2 years of camrelizumab. Objective response rate was 97.0%, with ongoing responses in 17 of the 32 responses (53.1%), and 93.9% (31 of 33) of the patients were alive at data cutoff. Safety profiles were consistent with the previous report, and no obvious evi-dence of cumulative toxicity was found with long exposure to camrelizumab.Conclusions: Camrelizumab plus carboplatin and peme-trexed provides long-term survival benefit over chemo-therapy, with manageable toxicity and remarkable and durable response in patients receiving 2 years of camreli-zumab, further supporting camrelizumab combination as first-line treatment for advanced nonsquamous NSCLC.& COPY; 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Automated summary

The addition of camrelizumab to first-line chemotherapy significantly improves the progression-free survival of patients with advanced nonsquamous NSCLC. It provides long-term survival benefit with manageable toxicity and durable response. These results support the combination of camrelizumab and chemotherapy as a first-line treatment for advanced nonsquamous NSCLC.