Phase 2 trial of camrelizumab plus apatinib for refractory chordoma

Current treatments for chordoma have limited efficacy. A phase 2 trial at the Second Affiliated Hospital of the Naval Medical University (Shanghai, China) evaluated the combination of an immune checkpoint inhibitor and an antiangiogenic drug for refractory chordoma. Thirty-three patients camrelizumab 200 mg once every two weeks plus apatinib 250 mg and 500 mg on alternate days. The primary endpoint was objective response rate ORR, per RECIST version 1.1). Median duration of follow-up was 20.8 months (IQR 13.35-26.55). RECIST-ORR was 24.2% (95% CI 11.0-38.9) whereas Choi-ORR was 48.5% (30.8-66.5). Median duration of response was not reached per RECIST and 22.2 months per Choi criteria. Median progression-free survival was 28.4 months ((5% CI 13.53-43.28). The most common grade 3 or 4 treatment-related adverse events were increased aspartate aminotransferase (39.4%) and alanine aminotransferase (33.3%); no treatment-related death occurred. The authors conclude that combination of camrelizumab and apatinib offered encouraging efficacy with manageable toxicity in chordoma treatment.