Camrelizumab and Apatinib Combined with Radiotherapy Is Effective in Advanced Oligometastatic Non-Small-Cell Lung Cancer

Abstract

Objective. To investigate the effect of camrelizumab + apatinib combined with radiotherapy on the expression of TRIM27, SCC-Ag, and CYFRA21-1 in advanced oligometastatic non-small-cell lung cancer (NSCLC). Methods. A retrospective analysis of patients with oligometastatic NSCLC who were treated at our hospital from January 1, 2021, to March 31, 2022. Patients who met the inclusion criteria were summarized into an observation group (camrelizumab on the basis of the control group), or a control group (radiotherapy combined with oral apatinib). The disease control rate, immune function, changes in the levels of TRIM27, SCC-Ag, CYFRA21-1, and the occurrence of adverse effects were compared between the two groups. Result. There were 86 patients who met the inclusion criteria, with 53 cases in the observation group and 33 cases in the control group. There were significant differences in complete remission (CR, 25/53 vs. 10/33), partial remission (PR, 17/53 vs. 12/33), disease control (DC, 7/53 vs. 4/33), disease progression (DP, 4/53 vs. 7/33), and disease control rate (49/53 vs. 26/33) between the observation group and the control group. There was no significant difference in immune function between the two groups before treatment ( p > 0.05 ). After treatment, the levels of CD3+, CD4+, CD4+/CD8+t cells, and NK cells in the observation group were higher ( p = 0.015 , 0.035, 0.003, 0.001, respectively), while the level of CD8+t cells was lower ( p < 0.001 ). There were no significant differences in TRIM27, SCC-Ag, or CYFRA21-1 between the two groups before treatment ( p > 0.05 ). After treatment, the observation group had lower levels of TRIM27 ( p = 0.035 ), SCC-Ag ( p = 0.045 ), and CYFRA21-1 ( p = 0.003 ). There was no significant difference in the occurrence of adverse events between the two groups ( p < 0.05 ). Conclusion. Treatment of camrelizumab + apatinib combined with radiotherapy is effective for advanced oligometastatic NSCLC, with mild adverse effects.

Oligo-Metastatic Cancers: Putative Biomarkers, Emerging Challenges and New Perspectives

“…Unfortunately, while DLTs, particularly SRT, are widely used in clinical practice to manage OMD, there is limited evidence to support their use. A review of scientific literature from PubMed in the past year (when a peak of publications is registered) reveals a high number of heterogeneous, retrospective, and small-scale clinical studies conducted in real-world settings [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. While these studies are important, their results cannot formally change the standard of therapy.…”

“…While these studies are important, their results cannot formally change the standard of therapy. The evidence ranges from case reports and retrospective series [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ] to phase III randomized trials [ 69 ] such as the SINDAS trial. This trial showed that adding SRT to TKIs significantly improves survival in 133 EGFR-mutated NSCLC OMD patients (median OS TKI plus SRT: 25.5 months vs. 17.4 months in TKI monotherapy).…”

“…The median survivals achieved in these studies with SRT are higher than those reported in the poly-metastatic setting, 30.8 and 53.4 months, respectively, confirming that OMD has a good prognosis. However, examples of systemic approaches have also been pursued and published in the past year in OMD, including immuno-plus chemotherapy [ 61 , 62 ] and immune therapy plus SRT [ 66 ]. These studies are retrospective, heterogeneous (patients received different treatments before and/or after the therapeutic approach for OMD), and lacking in comparison with a “control” arm.…”

Efficacy and safety of PD1/PDL1 inhibitors combined with radiotherapy and anti-angiogenic therapy for solid tumors: A systematic review and meta-analysis

“…This study included subgroup analyses. Among the different therapeutic regimens, RIT plus chemotherapy (RITC) therapy was administered in 2 studies, [13,21] and the pooled ORR and DCR were 50% (95% CI: .079 0.00, .396 [13,18,21] Skin reaction 14 9-19 .00 0.00, .5 [13,14,[16][17][18]20,21] Aspartate aminotransferase increased 18 13-25 .00 0.00, .98 [17][18][19][20] Alanine aminotransferase increased 22 14-31 .00 0.00, .91 [17,18,20] Anemia 20-80%, P = .001) and 69% (95% CI: 39-99%), respectively, while the pooled ORR and DCR were 61% (95% CI: 49-73%, P = .00) and 95% (95% CI: 83-107%) in the RIT therapy group. ORR in the RIT group was pooled using a random-effect model because of slight heterogeneity (I 2 = 47.6%, P = .075) (Figs.…”

“…After eliminating duplicates (n = 257), titles and abstracts were browsed and filtered. The full text of the remaining 42 studies was screened, and 10 articles [13][14][15][16][17][18][19][20][21][22] were finally included according to the inclusion criteria. The literature review and identification processes are shown in Figure 1.…”