Multicenter phase 3 trial of adjuvant camrelizumab for locoregionally advanced nasopharyngeal carcinoma

Approximately 20% to 30% of patients with locoregionally advanced nasopharyngeal carcinoma (LRA NPC) experience disease relapse after definitive chemoradiotherapy (CRT). Camrelizumab (anti-PD-1) has demonstrated considerable value in recurrent or metastatic NPC, while its role in LRA NPC is unclear. The phase 3 DIPPER trial, at 11 centers in China, evaluated adjuvant camrelizumab for LRA NPC. The trial included patients with T4N1M0 or T1-4N2-3M0 NPC who had completed induction CRT. Patients were randomized to 12 three-week cycles of camrelizumab or observation (standard therapy group). After a median follow-up of 39 months (IQR 33-50) the 3-year event-free survival was 86.9% in the camrelizumab group and 77.3% in the standard therapy group (sHR 0.56; p=0.01). Grade 3 or 4 adverse events were reported for 11.2% of patients in the camrelizumab group and 3.2% of patients in the standard therapy group. There was no significant deterioration in quality of life in the camrelizumab group. The authors conclude that among patients with LRA NPC, adjuvant camrelizumab significantly improved EFS with manageable toxicities (visual abstract).