ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Camrelizumab plus albumin-bound paclitaxel and S-1 as first-line treatment for patients with human epidermal growth factor receptor 2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a phase 2 trial
Provisionally accepted
- Henan Cancer Hospital Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
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Background: Current first-line treatment options for human epidermal growth factor receptor 2 (HER2)-negative advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma have limited efficacy. This study aimed to evaluate the efficacy and safety of camrelizumab plus albumin-bound paclitaxel and S-1 as first-line treatment for this population. Methods: In this phase 2 trial (NCT04675866), patients received albumin-bound paclitaxel (125 mg/m2, days 1 and 8) and S-1 (40-60 mg per body surface area, twice daily on days 1-14) for 4-6 cycles of 21 days each. Camrelizumab (200 mg every 3 weeks) was concurrently initiated and continuously administered until disease progression, intolerable toxicity, or completion of 2-year treatment. The primary endpoint was objective response rate (ORR). Results: Between December 2020 and December 2024, 47 patients were enrolled. By the data cutoff date (January 6, 2025), the median follow-up duration was 16.7 months (range, 1.6-42.2 months). Among the 40 patients with evaluable efficacy, the ORR was 67.5% (95% CI: 52.3%-82.7%). The disease control rate was 95.0%. Median progression-free survival was 7.8 (95% CI: 6.2-9.4) months, and median overall survival was 23.8 (95% CI: 15.2-32.4) months. Grade 3-4 treatment-related adverse events(TRAEs) occurred in 18 patients (38.3%), with the most common being decreased neutrophil count (12 [25.5%]) and anemia (four [8.5%]). Conclusion: The combination of camrelizumab, albumin-bound paclitaxel, and S-1 as first-line treatment for patients with HER2-negative advanced G/GEJ adenocarcinoma showed promising efficacy and an acceptable safety profile. Randomized controlled clinical trials are required to further demonstrate its efficacy and optimal application scenario.
Keywords: gastric or gastroesophageal junction adenocarcinoma, camrelizumab, Albumin-bound paclitaxel, Human epidermal growth factor receptor 2-negative, S-1
Received: 24 May 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Wu, Li and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xinfang Hou
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