卡雷珠单抗在晚期肝细胞癌中的临床应用

StephenW

The clinical application of camrelizumab on advanced hepatocellular carcinoma
Zhongguang Chen , Xiuhua Lu & Kelly Koral
Received 20 May 2020, Accepted 06 Aug 2020, Accepted author version posted online: 07 Aug 2020, Published online: 18 Aug 2020

    Download citation https://doi.org/10.1080/17474124.2020.1807939 CrossMark Logo CrossMark

ABSTRACT
Introduction

Camrelizumab (also known as SHR-1210), a humanized monoclonal antibody against PD-1, has been shown to block the binding of PD-1 to PD-L1 and consequently inhibit the immune escape of tumor cells. Recently, camrelizumab was approved as a second-line drug for previously treated advanced hepatocellular carcinoma in China.
Areas covered

In this paper, the chemical properties, mechanism of action, pharmacokinetics, clinical efficacy, safety, and tolerability of camrelizumab for the treatment of advanced hepatocellular carcinoma are introduced in detail. The strategy for combination therapy and the potential application of camrelizumab in other solid tumors are briefly described. We performed a systematic review of the literature in PubMed and the following keywords were used: ‘SHR-1210,’ ‘Camrelizumab,’ and ‘hepatocellular carcinoma.’
Expert opinion

Camrelizumab is a selective, humanized, high-affinity IgG4 kappa mAb against PD-1. Camrelizumab showed promising antitumor activity and manageable toxicities and offers a new second-line drug option for patients with advanced hepatocellular carcinoma. Reactive cutaneous capillary endothelial proliferation is a novel but prevalent immune-related dermatologic toxicity of camrelizumab, which is mild, reversible, and predictable. More clinical trials of camrelizumab are ongoing to develop combination therapy strategies and new indications for malignancies.
KEYWORDS: Advanced hepatocellular carcinoma, camrelizumab, PD-1, SHR-1210, immunotherapy
Additional information
Funding
This paper was funded by the Key Research & Development Program of Shandong Province (2018GGX109006).
Article highlights

    Camrelizumab is a selective, humanized, high-affinity IgG4 kappa mAb against PD-1.

    Camrelizumab binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, thus blocking immunosuppression mediated by the PD-1 pathway including antitumor immune response, resulting in antitumor activity.

    Camrelizumab was approved as a second-line drug by the NMPA for the treatment of patients with advanced HCC, who have previously received sorafenib treatment and/or oxaliplatin systemic chemotherapies.

    Recommended dosage of camrelizumab for advanced HCC patients: 3 mg/kg intravenously every 3 weeks until disease progression or intolerable toxicity.

    Camrelizumab is well tolerated with a manageable toxicity profile. Most frequent AEs are RCCEP, anemia, fever, fatigue, hypothyroidism, proteinuria, cough, and decreased appetite.

StephenW

卡雷珠单抗在晚期肝细胞癌中的临床应用
陈忠光，陆秀华和Kelly Koral
于2020年5月20日收到，于2020年8月6日接受，在网上发布的作者版本为：2020年8月7日，在线发布为：2020年8月18日

    下载引文https://doi.org/10.1080/17474124.2020.1807939 CrossMark徽标CrossMark

抽象
介绍

卡米珠单抗（也称为SHR-1210），一种针对PD-1的人源化单克隆抗体，已显示出可阻断PD-1与PD-L1的结合，从而抑制肿瘤细胞的免疫逃逸。最近，卡雷珠单抗被批准为中国先前治疗的晚期肝细胞癌的二线药物。
覆盖区域

本文详细介绍了卡来珠单抗治疗晚期肝细胞癌的化学性质，作用机理，药代动力学，临床疗效，安全性和耐受性。简要介绍了联合治疗的策略以及Camrelizumab在其他实体瘤中的潜在应用。我们对PubMed中的文献进行了系统的审查，并使用了以下关键词：“ SHR-1210”，“卡瑞珠单抗”和“肝细胞癌”。
专家意见

Camrelizumab是针对PD-1的选择性，人源化，高亲和力IgG4κ单抗。卡米珠单抗显示出有希望的抗肿瘤活性和可控制的毒性，并为晚期肝细胞癌患者提供了新的二线药物选择。皮肤毛细血管内皮反应性增生是一种新的但普遍存在的卡雷珠单抗的免疫相关皮肤毒性，其轻度，可逆和可预测。 Camrelizumab的更多临床试验正在进行中，以开发联合治疗策略和恶性肿瘤的新适应症。
关键词：晚期肝细胞癌，卡莫珠单抗，PD-1，SHR-1210，免疫治疗
附加信息
资金
该论文由山东省重点研究发展计划（2018GGX109006）资助。
文章重点

    Camrelizumab是针对PD-1的选择性，人源化，高亲和力IgG4κ单抗。

    卡米珠单抗结合至PD-1受体并阻断其与PD-L1和PD-L2的相互作用，从而阻断由PD-1途径介导的免疫抑制，包括抗肿瘤免疫反应，从而产生抗肿瘤活性。

    Camrelizumab被NMPA批准为二线药物，用于治疗晚期HCC患者，这些患者先前曾接受过索拉非尼治疗和/或奥沙利铂全身化疗。

    晚期肝癌患者推荐使用卡雷珠单抗的剂量：每3周静脉注射3 mg / kg，直至疾病进展或无法忍受的毒性。

    Camrelizumab的耐受性良好，毒性可控。最常见的AE是RCCEP，贫血，发烧，疲劳，甲状腺功能减退，蛋白尿，咳嗽和食欲下降。