Camrelizumab plus apatinib shows promising safety, efficacy in ESCC

Treatment with camrelizumab combined with apatinib demonstrates improvements in overall survival (OS), progression-free survival (PFS), and response rates in patients with esophageal squamous cell carcinoma (ESCC), a study has shown.

A team of investigators systematically searched the databases of PubMed, Embase, Cochrane, Scopus, and clinicaltrials.gov from inception to May 2025. Nine studies examining the safety and efficacy of camrelizumab plus apatinib met the inclusion criteria.

The investigators performed the analysis on R Studio version 4.5.0 and reported pooled estimates as proportions using a random-effects model. They also assessed heterogeneity and conducted a subgroup analysis based on treatment exposure.

Pooled results showed a 71-percent OS rate at 1 year, with treatment-naïve patients exhibiting a statistically higher 1-year OS than pretreated patients (95 percent vs 55 percent). Furthermore, PFS at 1 year was 25 percent.

The treatment-naïve group showed a significantly higher overall response rate than the previously treated group (87 percent vs 28 percent). Treatment-naïve patients also had a significantly higher CRR than those who had been previously treated (22 percent vs 1 percent). Likewise, partial response rate was significantly higher in the treatment-naïve group (64 percent vs 26 percent).

In terms of safety, the most common adverse event was hemangioma, occurring in 47 percent of patients in the treatment-naïve group and 12 percent in the previously treated group. The rates of leukopenia, neutropenia, anaemia, and thrombocytopenia did not significantly differ between groups.

“Large-scale trials are warranted to validate these findings and optimize treatment strategies,” the investigators said.

“Combining immunotherapy with antiangiogenic agents has shown promise. Camrelizumab, a PD-1 inhibitor, and apatinib, a VEGFR-2 inhibitor, offer synergistic effects, improving outcomes in patients with advanced or metastatic ESCC,” they said.