Evaluating the effectiveness and safety of camrelizumab in combination with XELOX chemotherapy plus bevacizumab or regorafenib in patients with advanced colorectal cancer.

This study investigated the effectiveness and safety of camrelizumab (SHR1210) in combination with XELOX (capecitabine and oxaliplatin) chemotherapy plus bevacizumab (Avastin) or regorafenib (Stivarga) as first-line therapy in patients with metastatic colorectal cancer (mCRC). The data showed that the combination was effective for these patients with manageable side effects.

Colorectal cancer (CRC) is one of the most common types of cancer worldwide. Some patients do not report symptoms with the initial tumor. These patients are often only diagnosed when the cancer has spread to other areas (mCRC). The standard treatment for these patients is chemotherapy combined with targeted therapy.

Bevacizumab and regorafenib are types of targeted therapy. They target cancer cells by stopping their growth and also stop the production of new blood vessels in tumors which often occurs in mCRC. This can help to slow the spread of cancer. Studies have shown that bevacizumab and regorafenib improve the outcomes of patients with mCRC when added to chemotherapy such as XELOX.

Camrelizumab is a type of immunotherapy. This drug targets a protein called PD-1 on the surface of cancer cells that drives tumor growth. Blocking PD-1 restores the capacity of the immune system to attack and kill cancer cells. Camrelizumab has been shown to improve the outcomes of patients with Hodgkin lymphoma, a type of cancer of the immune system. However, the effectiveness and safety of camrelizumab in combination with XELOX chemotherapy plus bevacizumab or regorafenib as first-line therapy in patients with mCRC are still unknown.

This study involved 25 patients with mCRC. 19 patients received a combination of camrelizumab with XELOX chemotherapy plus bevacizumab. 6 patients received a combination of camrelizumab with XELOX chemotherapy plus regorafenib. The average follow-up time was 11.5 months.

Overall, 18 (72%) patients responded to the treatment. None of the patients achieved a complete response (complete disappearance of cancer cells). 18 (72%) patients achieved a partial response (partial disappearance of cancer cells). 24 (96%) patients achieved disease control (tumor does not grow or spread).

The average overall survival was not reached (exceeded the follow-up time). Overall, 70.4% of the patients were alive after 1 year. The average survival without cancer worsening was 11.2 months.

8 (32%) patients experienced severe side effects. The most common side effects were low white blood cell counts, redness, swelling, and pain on the palm of the hand and sole of the foot, and liver damage.  

This study concluded that camrelizumab in combination with XELOX chemotherapy plus bevacizumab or regorafenib was effective for patients with mCRC with manageable side effects.

This study looked back in time at medical records. The sample size was very small and only included patients from a single institution in China. There was also no comparison group. Larger studies at different institutions are required to validate the conclusions.