Neoadjuvant Camrelizumab and Apatinib Combined with Chemotherapy for Locally Advanced Gastric Cancer: A Randomized, Multicenter, Open-Label, Phase 2 Trial

Recent efficacy and safety analysis of neoadjuvant therapy with Tislelizumab combined with Apatinib and chemotherapy in Borrmann type IV, large Borrmann type III, and Bulky N locally advanced gastric cancer(3-B).

“…Considering this study and the ndings from Li S [30], Arise-FJ-G 005 [31], and DRAGON-IV/AHEAD-G208 [32], the "targeted-immunotherapy" triplet regimen for perioperative gastric cancer treatment offers a new strategy, demonstrating signi cant e cacy as well as good safety and tolerability overall.…”

“…Moderately differentiated adenocarcinomas correspond to the intestinal type in the Lauren classi cation and show a better pathological response to neoadjuvant therapy. In the Arise-FJ-G 005 study [31], for diffuse-type tumors, the MPR rate in the CA-SAP group was signi cantly higher than in the SAP group (34.2% vs. 12.5%, P = 0.022). Therefore, it is believed that although the pathological e cacy of the "targeted-immunotherapy" triplet neoadjuvant therapy regimen is lower for diffuse-type gastric cancer compared to intestinal-type, the "targeted-immunotherapy" triplet regimen has already signi cantly improved the pathological e cacy in diffuse-type gastric cancer compared to chemotherapy alone.…”

“…Studies like CheckMate-649 [24], ATTRACTION-4 [25], and ORIENT-16 [26] support that patients with PD-L1 CPS ≥ 5 bene t more from the addition of immunotherapy to chemotherapy. A subgroup analysis in the Arise-FJ-G 005 study [31] showed that among 45 patients with CPS < 1, the MPR rates in the CA-SAP group and the SAP group were 27.3% and 17.4% (P = 0.331), respectively. Among 54 patients with CPS ≥ 1, the MPR rates in the CA-SAP group and the SAP group were 40.7% and 18.5% (P = 0.068), respectively.…”

“…Therefore, it is considered that the combination of Tislelizumab with apatinib and the SOX regimen is safe and feasible for neoadjuvant therapy in LAGC. [31] by Fujian Medical University Union Hospital explored the combination of Camrelizumab and Apatinib with the albumin-bound paclitaxel plus S-1 (CA-SAP) regimen versus the SAP regimen alone for neoadjuvant therapy in LAGC, showing the CA-SAP group had signi cantly higher objective response rates (66.0% vs 43.4%, P = 0.017) and R0 resection rates (94.1% vs 81.1%, P = 0.042) than the SAP group. The PCR rate was higher in the CA-SAP group (16.3%) compared to the SAP group (6.0%), although the difference was not statistically signi cant (P = 0.094).…”