The clinical application of camrelizumab on advanced hepatocellular carcinoma

ABSTRACT

Introduction

Camrelizumab (also known as SHR-1210), a humanized monoclonal antibody against PD-1, has been shown to block the binding of PD-1 to PD-L1 and consequently inhibit the immune escape of tumor cells. Recently, camrelizumab was approved as a second-line drug for previously treated advanced hepatocellular carcinoma in China.

Areas covered

In this paper, the chemical properties, mechanism of action, pharmacokinetics, clinical efficacy, safety, and tolerability of camrelizumab for the treatment of advanced hepatocellular carcinoma are introduced in detail. The strategy for combination therapy and the potential application of camrelizumab in other solid tumors are briefly described. We performed a systematic review of the literature in PubMed and the following keywords were used: ‘SHR-1210,’ ‘Camrelizumab,’ and ‘hepatocellular carcinoma.’

Expert opinion

Camrelizumab is a selective, humanized, high-affinity IgG4 kappa mAb against PD-1. Camrelizumab showed promising antitumor activity and manageable toxicities and offers a new second-line drug option for patients with advanced hepatocellular carcinoma. Reactive cutaneous capillary endothelial proliferation is a novel but prevalent immune-related dermatologic toxicity of camrelizumab, which is mild, reversible, and predictable. More clinical trials of camrelizumab are ongoing to develop combination therapy strategies and new indications for malignancies.

KEYWORDS:

• Advanced hepatocellular carcinoma
• camrelizumab
• PD-1
• SHR-1210
• immunotherapy

Article highlights

• Camrelizumab is a selective, humanized, high-affinity IgG4 kappa mAb against PD-1.

• Camrelizumab binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, thus blocking immunosuppression mediated by the PD-1 pathway including antitumor immune response, resulting in antitumor activity.

• Camrelizumab was approved as a second-line drug by the NMPA for the treatment of patients with advanced HCC, who have previously received sorafenib treatment and/or oxaliplatin systemic chemotherapies.

• Recommended dosage of camrelizumab for advanced HCC patients: 3 mg/kg intravenously every 3 weeks until disease progression or intolerable toxicity.

• Camrelizumab is well tolerated with a manageable toxicity profile. Most frequent AEs are RCCEP, anemia, fever, fatigue, hypothyroidism, proteinuria, cough, and decreased appetite.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the Key Research & Development Program of Shandong Province (2018GGX109006).