Clinical efficacy and safety of camrelizumab combined with apatinib and chemotherapy as second-line or later therapy in the treatment of HER-2 negative advanced gastric cancer / 国际肿瘤学杂志

Objective:To explore the clinical efficacy and safety of the camrelizumab combined with apatinib and chemotherapy as second-line or later therapy in human epidermal growth factor receptor-2 (HER-2) negative advanced gastric cancer.Methods:A total of 66 patients with HER-2 negative advanced gastric cancer and first-line treatment failure in Shandong Cancer Hospital Affiliated to Shandong First Medical University from March 2018 to September 2021 were selected. They were divided into study group ( n=22) and control group ( n=44) according to the different treatment regimens. The patients in the study group were treated with camrelizumab combined with apatinib and chemotherapy, and the patients in the control group were treated with chemotherapy alone. The short-term efficacy, progression-free survival (PFS) , overall survival (OS) and the occurrence of adverse reactions were compared, and Cox regression analysis was used to analyze the influencing factors of prognosis. Results:After at least 2-4 cycles of treatment, the ORR in the study group and the control group were 9.1% (2/22) and 0 (0/44) respectively, with no statistically significant difference ( P=0.108) . DCR in the two groups were 77.3% (17/22) and 45.5% (20/44) respectively, with a statistically significant difference ( χ2=6.03, P=0.014) . The study group didn’t reach median OS and the median OS in the control group was 11.7 months, with no statistically significant difference ( χ2=1.59, P=0.207) . The study group didn’t reach median PFS and the median PFS in the control group was 3.2 months, with a statistically significant difference ( χ2=10.13, P=0.001) . Multivariate Cox regression analysis showed that treatment method was an independent influencing factor for PFS in patients with HER-2 negative advanced gastric cancer ( HR=0.33, 95% CI: 0.15-0.75, P=0.008) . In terms of adverse reactions, there was a statistically significant difference in the incidence of elevated alanine aminotransferase between the study group and the control group [31.8% (7/22) vs. 6.8% (3/44) , χ2=5.32, P=0.021]. There were no adverse-related deaths in both groups. Conclusion:Compared with chemotherapy alone, camrelizumab combined with apatinib and chemotherapy as a second-line or later therapy in HER-2 negative advanced gastric cancer can prolong PFS and improve DCR, but the incidence of elevated alanine aminotransferase increases significantly.

Progress of treatment for primary mediastinal B-cell lymphoma / 国际肿瘤学杂志

Primary mediastinal B-cell lymphoma (PMBCL) is aggressive B-cell lymphoma with unique clinicopathologic characteristics.However,under the new classification of PMBCL,whether R-CHOP was the standard first-line immunotherapy regimen remains a controversy.The DA-EPOCH-R is not inferior to R-CHOP,but attention should be paid to the toxic effects.PMBCL is a radiosensitive disease,but radiotherapy did not as the front-line therapy for PMBCL.A biopsy is required for positive PET/CT after immunotherapychemotherapy to determine the further treatment of PMBCL.Recurrent/refractory PMBCL,with poor prognosis,salvage immunochemotherapy is often used followed by high-dose chemotherapy and autologous stem cell transplant.PD-1 overexpression is common in recurrent/refractory PMBCL,and immune checkpoint inhibitors are potential to be an important treatment option.Recently,the development of molecular medicine has provided a new basis for the selection of targets in PMBCL,however,it needs to be further confirmed by clinical trials.