An exploratory study of safety and efficacy of camrelizumab plus induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma

This study aims to prospectively evaluate the safety and efficacy of camrelizumab plus induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) in locally advanced nasopharyngeal carcinoma (LA-NPC). This prospective study (ChiCTR2500102158) enrolled patients with histologically confirmed LA-NPC. The neoadjuvant regimen consisted of camrelizumab combined with chemotherapy, followed by CCRT. The primary endpoint was the complete response (CR) rate; the secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS). Treatment-related adverse events were documented. Between September 2022 and February 2025, 30 patients were enrolled. After neoadjuvant therapy, the CR rate, ORR, and DCR were 23.3%, 96.7% and 100%, respectively. Among the 29 patients evaluable at 16 weeks after CCRT, 27 achieved CR and 2 achieved PR, corresponding to a CR rate of 93.1% and an ORR and DCR of 100%. Regarding treatment-related toxicity, grade III–IV acute adverse events occurred in 9 patients (30.0%). Grade 1 or 2 reactive cutaneous capillary endothelial proliferation (RCCEP), associated with camrelizumab, was observed in 12 patients (40.0%). Notably, no severe immune-related adverse events (irAEs) were reported. With a median follow-up of 29 months, only one patient developed regional recurrence. The estimated 2-year OS and PFS rates were 100% and 95.5%, respectively. Camrelizumab combined with induction chemotherapy followed by CCRT demonstrated high CR, ORR, and DCR rates in LA-NPC, with a favorable safety profile and no severe irAEs.