A pilot study of camrelizumab with docetaxel and cisplatin for the first line treatment in recurrent/metastatic oral squamous cell carcinoma

Pembrolizumab with cisplatin and 5‐fluorouracil showed survival benefit but relatively high occurrence of treatment‐related adverse events (TRAEs) for recurrent/metastatic oral squamous cell carcinoma (R/M OSCC). A more tolerable regime is needed. This trial enrolled 20 R/M OSCC patients with previously untreated and PD‐L1 positive. Patients were administered camrelizumab with docetaxel and cisplatin every 3 weeks for six cycles, followed by camrelizumab monotherapy every 3 weeks until disease progression or intolerable toxicity. The primary endpoint was occurrence of grade ≥ 3 TRAEs, secondary endpoints included overall survival (OS), progression‐free survival (PFS), and overall response rate (ORR). 45% patients experienced grade ≥ 3 TRAEs, which the most common were anemia (15%), stomatitis (15%), and neutropenia (10%). The most common potential immune‐related adverse events were reactive cutaneous capillary endothelial proliferation (RCCEP; 60%), hypothyroidism (35%), and pneumonitis (15%). No treatment‐related deaths occurred. The median OS, PFS, and ORR was 14.4 months, 5.35 months, and 40.0% respectively. The study also found RCCEP occurrence, lower FOXP3+ cells, and higher density of intratumor tertiary lymphoid structure were associated with improved efficacy. Our data suggest that camrelizumab with docetaxel/cisplatin as first‐line therapy was well tolerable and had potentially favorite efficacy in PD‐L1‐positive patients with R/M OSCC. This phase Ib trial enrolled patients diagnosed recurrent/metastatic oral squamous cell carcinoma (R/M OSCC) with previously untreated and PD‐L1 positive. Our data suggest that camrelizumab with docetaxel/cisplatin was well tolerable and had favorite efficacy in PD‐L1‐positive patients with R/M OSCC. The study also found the occurrence of reactive cutaneous capillary endothelial proliferation, lower expression of FOXP3, and density of intratumor tertiary lymphoid structure were associated with better efficacy.