First-line camrelizumab plus chemotherapy in patients with advanced non-squamous non-small cell lung cancer: A nationwide, retrospective real-world study.

Abstract

e20589 Background: Camrelizumab plus chemotherapy has been approved for the fist-line treatment of advanced non-squamous non-small cell lung cancer (NSCLC) since June 2020, based on the results from the phase 3 CameL study. Recently, the 5-year outcomes of CameL were disclosed. However, long-term results reflecting the effect of this combination strategy in real-world population are warranted. Methods: This was a nationwide, retrospective observational study of patients with advanced non-squamous NSCLC treated with first-line camrelizumab plus chemotherapy, conducted in China. Baseline characteristics, treatment information, overall survival (OS), and adverse events were reviewed, with indirect descriptive comparisons to CameL. Results: Before January 1, 2023, a total of 599 patients from 161 sites initiated treatment. Compared with CameL, the patients in this study were older (median: 65 years vs 59 years; ≥65 years: 50.8% vs. 22.0%), and more patients had brain metastases (12.4% vs. 4.9%). This study enrolled 46 (7.7%) patients with Eastern Cooperative Oncology Group performance status ≥2, while these patients were excluded from CameL. Due to poor tolerance, 137 (22.9%) patients received camrelizumab plus single-agent chemotherapy in this study, while all patients received camrelizumab plus platinum-based doublet chemotherapy in CameL. Median duration of camrelizumab treatment was 3.7 months in this study and 7.5 months in CameL. In this study, the median OS was 23.4 months (95% CI, 22.0-25.6) with a median follow-up duration of 20.5 months. In CameL, the median OS was 27.9 months (95% CI, 21.9 to not reached) when the median follow-up duration was 19.3 months, and 27.1 months (95% CI, 21.9-31.5) after 5-year results were updated. Of 599 patients in this study, the incidence of any-grade treatment-emergent adverse events (TEAEs) was 76.8%, and 13.9% of patients had grade ≥3 TEAEs. Conclusions: Compared with CameL, our patients had worse baseline characteristics and shorter duration of exposure to camrelizumab. Over one-fifth of patients selected single-agent chemotherapy as partner of camrelizumab. Even under this circumstance, this study still showed promising OS benefit with camrelizumab plus chemotherapy. Our data might better reflect the role of this combination strategy for the treatment of advanced non-squamous NSCLC in clinical practice. The study is ongoing to enroll more patients and extend follow-up, and 3- to 5-year real-world OS data are awaited.