{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:36:27Z","timestamp":1791822987658,"version":"4.3.4"},"reference-count":28,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018731","name":"Jiangsu Hengrui Pharmaceuticals Co., Ltd","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018731","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"Chinese National Natural Science Foundation Project","doi-asserted-by":"crossref","award":["No. 81972556 and No. 82072558"],"award-info":[{"award-number":["No. 81972556 and No. 82072558"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Medical Scientific Research Foundation of Guangdong Province","award":["C2018062"],"award-info":[{"award-number":["C2018062"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2021,11,16]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the antitumor activity of camrelizumab, an antiprogrammed cell death-1 antibody, in pretreated recurrent or metastatic nasopharyngeal carcinoma (NPC) and to explore predictive biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with recurrent (not amenable to locally curative treatment) or metastatic NPC who had failed at least two lines of chemotherapy were eligible to receive camrelizumab (200\u2009mg intravenously every 2 weeks) for 2 years or until disease progression, intolerable adverse events, withdrawal of consents, or investigator decision. The primary endpoint was objective response rate (ORR) assessed by an independent review committee (IRC). Programmed cell death-ligand 1 (PD-L1) expression was assessed by immunohistochemistry. Other immune-related biomarkers including major histocompatibility complex class I and major histocompatibility complex class II (MHC-II) were assessed by multiplex immunofluorescence staining.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between August 14, 2018, and December 30, 2019, a total of 156 patients were enrolled. The IRC-assessed ORR was 28.2% (95% CI 21.3% to 36.0%). The median progression-free survival was 3.7 months (95%\u2009CI 2.0 to 4.1) per IRC, and the median overall survival was 17.4 months (95%\u2009CI 15.2 to 21.9). The ORRs were 35.2% (95% CI 25.3% to 46.1%) vs 19.4% (95% CI 10.4% to 31.4%) in patients with tumor PD-L1 expression of \u226510%\u2009and&lt;10%, respectively. Patients with durable clinical benefit (DCB), which was defined as complete response, partial response or stable disease of \u226518 weeks, had higher density of MHC-II+ cell in stroma than patients without DCB (median 868.1 (IQR 413.4\u20132854.0)\u2009cells\/mm\n                      <jats:sup>2<\/jats:sup>\n                      vs median 552.4 (IQR 258.4 to 1242.1) cells\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ). MHC-II+ cell density did not correlate with PD-L1 expression, and a composite of high stromal MHC-II+ cell density and tumor PD-L1 expression further enriched patients who could benefit from camrelizumab.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Camrelizumab had clinically meaningful antitumor activity in patients with recurrent or metastatic NPC. The composition of both MHC-II+ cell density and PD-L1 expression could result in better patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jitc-2021-003790","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T12:30:56Z","timestamp":1640089856000},"page":"e003790","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":82,"title":["Efficacy, safety, and biomarker analysis of Camrelizumab in Previously Treated Recurrent or Metastatic Nasopharyngeal Carcinoma (CAPTAIN study)"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03558191","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yunpeng","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Radiotherapy, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianji","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Radiation Oncology, Fujian Cancer Hospital, Fuzhou, 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People's Hospital, Foshan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunyu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qitao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Oncology, Guangxi Medical University Affiliated Tumor Hospital, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desheng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Tumor Radiotherapy, Hubei Cancer Hospital, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Beijing Cancer Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyuan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 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