Multicenter phase 3 trial of perioperative camrelizumab plus rivoceranib plus chemotherapy for locally advanced gastric cancer: pathologic response results

The multicenter phase 3 DRAGON IV/CAP05 trial in China randomized patients with locally advanced gastric or gastroesophageal junction (LA G/GEJ) adenocarcinoma to perioperative camrelizumab (anti-PD-1) plus low-dose rivoceranib (VEGFR-2 inhibitor) plus S-1 and oxaliplatin (SOX) chemotherapy (SOXRC group; n=180) or SOX chemotherapy alone (n=180). Primary endpoints were pathologic complete response (pCR) rates and event-free survival. The pCR results have now been published. pCR rate was 18.3% in the SOXRC group versus 5.0% in the SOX group (OR 4.5; p<0.001). Surgical complications and grade ≥ 3 neoadjuvant treatment-related adverse events occurred in 27% versus 33% and 34% versus 17% in SOXRC and SOX, respectively. The authors conclude that addition of camrelizumab and low-dose rivoceranib to neoadjuvant SOX chemotherapy for LA G/GEJ adenocarcinoma was associated with significant improvement of the pCR rate, with a tolerable safety profile.