PT - JOURNAL ARTICLE AU - Yang, Yunpeng AU - Zhou, Ting AU - Chen, Xiaozhong AU - Li, Jingao AU - Pan, Jianji AU - He, Xiaohui AU - Lin, Lizhu AU - Shi, Ying-rui AU - Feng, Weineng AU - Xiong, Jianping AU - Yang, Kunyu AU - Yu, Qitao AU - Zhang, Qunling AU - Hu, Desheng AU - Sun, Yan AU - Hu, Guangyuan AU - Li, Ping AU - Shen, Liangfang AU - Lin, Qin AU - Zhang, Ben AU - Qu, Xiao AU - Zou, Jianjun AU - Zhang, Li AU - Fang, Wenfeng AU - Zhao, Yuanyuan TI - Efficacy, safety, and biomarker analysis of Camrelizumab in Previously Treated Recurrent or Metastatic Nasopharyngeal Carcinoma (CAPTAIN study) AID - 10.1136/jitc-2021-003790 DP - 2021 Dec 01 TA - Journal for ImmunoTherapy of Cancer PG - e003790 VI - 9 IP - 12 4099 - http://jitc.bmj.com/content/9/12/e003790.short 4100 - http://jitc.bmj.com/content/9/12/e003790.full SO - J Immunother Cancer2021 Dec 01; 9 AB - Background This study aimed to evaluate the antitumor activity of camrelizumab, an antiprogrammed cell death-1 antibody, in pretreated recurrent or metastatic nasopharyngeal carcinoma (NPC) and to explore predictive biomarkers.Methods Patients with recurrent (not amenable to locally curative treatment) or metastatic NPC who had failed at least two lines of chemotherapy were eligible to receive camrelizumab (200 mg intravenously every 2 weeks) for 2 years or until disease progression, intolerable adverse events, withdrawal of consents, or investigator decision. The primary endpoint was objective response rate (ORR) assessed by an independent review committee (IRC). Programmed cell death-ligand 1 (PD-L1) expression was assessed by immunohistochemistry. Other immune-related biomarkers including major histocompatibility complex class I and major histocompatibility complex class II (MHC-II) were assessed by multiplex immunofluorescence staining.Results Between August 14, 2018, and December 30, 2019, a total of 156 patients were enrolled. The IRC-assessed ORR was 28.2% (95% CI 21.3% to 36.0%). The median progression-free survival was 3.7 months (95% CI 2.0 to 4.1) per IRC, and the median overall survival was 17.4 months (95% CI 15.2 to 21.9). The ORRs were 35.2% (95% CI 25.3% to 46.1%) vs 19.4% (95% CI 10.4% to 31.4%) in patients with tumor PD-L1 expression of ≥10% and<10%, respectively. Patients with durable clinical benefit (DCB), which was defined as complete response, partial response or stable disease of ≥18 weeks, had higher density of MHC-II+ cell in stroma than patients without DCB (median 868.1 (IQR 413.4–2854.0) cells/mm2 vs median 552.4 (IQR 258.4 to 1242.1) cells/mm2). MHC-II+ cell density did not correlate with PD-L1 expression, and a composite of high stromal MHC-II+ cell density and tumor PD-L1 expression further enriched patients who could benefit from camrelizumab.Conclusions Camrelizumab had clinically meaningful antitumor activity in patients with recurrent or metastatic NPC. The composition of both MHC-II+ cell density and PD-L1 expression could result in better patient selection.Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author upon reasonable request.