Use of immune repertoire sequencing analysis to detect differences in treatment responses for advanced esophageal squamous cell carcinoma treated with camrelizumab and platinum-based chemotherapy.

• DOI: 10.1200/jco.2025.43.4_suppl.488
• Publication Date: 2025-01-27T14:37:03Z
• Authors: Xiaoling Zhang; Wenqi Zhao; Yunyi Du; Fei Su; Hui Wang; Yuexiang Zhang; Ning Ma; Wei Yang; Bo Yang; Min Liu; Yangjun Gao; Chunmei Yao; Ning Xu; Yu Wang; Yongai Li; Guohua Song; Wenqing Hu; Jun Zhao

488 Background: The study evaluated the efficacy and safety of camrelizumab combined with platinum-based chemotherapy (platinum plus paclitaxel [TP] or fluorouracil [FP] agents) as first-line treatment in patients advanced esophageal squamous cell carcinoma (ESCC), explored potential biomarkers for response using immune repertoire (IR) sequencing. Methods: In this multi-center, prospective cohort study, ESCC were treated TP FP chemotherapy. Primary outcome was 1-year progression free survival (PFS). Secondary outcomes included overall (OS), objective rate (ORR), disease control (DCR) safety. Patients categorized based on their responses into non-ORR ORR groups. IR sequencing exploratorily performed peripheral blood mononuclear cells from 15 each group. Results: From June 2020 to April 2023, 88 out 98 screened enrolled, a median follow-up 15.9 months. PFS 56.8%, OS 68.2%, 64.8%, DCR 91.1%. Most treatment-related adverse events grade 1-2, though 12.5% experienced ≥3 toxicities. regimen's comparable regimen. analysis complementarity-determining region 3 polypeptide sequences revealed significant differences amino acid composition between groups T-cell receptor beta-chain (TRB) immunoglobulin heavy chain (IGH) repertoire. Furthermore, group exhibited more concentrated distribution clones within TRB. Two V genes (TRBV29-1 TRBV4-1) one J gene (TRBJ1-3) TRB region, along six (IGHV1-45, IGHV3-20, IGHV3-48, IGHV3-49, IGHV4-4, IGHV5-51) IGH differentially expressed two Conclusions: Camrelizumab is effective well-tolerated ESCC. may provide insights underlying mechanisms influencing response. Clinical trial information: ChiCTR2000037942. Objective Efficacy evaluation Total (N=88) T（n=69） (n=19) p 50/88 (56.8%) 39/69 (56.5%) 11/19 (57.9%) 1.000 60/88 (68.2%) 47/69 (68.1%) 13/19 (68.4%) 57/88 (64.8%) 43/69 (62.3%) 0.793 81/88 (91.1%) 63/69 (91.3%) 15/19 (79.0%) 0.213 group, n (%) 54/88 (61.4%) (57.89%) Non-ORR Group, 34/88 (38.6%) 26/69 (37.7%) 8/19 (42.1%) 2-year 38/88 (43.2%) 30/69 (43.5%) 42/88 (47.7%) 33/69 (47.8%) 9/19 (47.4%) *p<0.05, statistically difference.