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Safety, efficacy and tumor mutational burden as a biomarker of overall survival benefit in chemo-refractory gastric cancer treated with toripalimab, a PD-1 antibody in phase Ib/II clinical trial NCT02915432

Open access
Wang, F., Wei, X.L., Wang, F.H., Xu, N., Shen, L., Dai, G.H., Yuan, X.L., Chen, Y., Yang, S.J., Shi, J.H., Hu, X.C., Lin, X.Y., Zhang, Q.Y., Feng, J.F., Ba, Y., Liu, Y.P., Li, W., Shu, Y.Q., Jiang, Y., Li, Q., Wang, J.W., Wu, H., Feng, H., Yao, S., Xu, R.H.·2019·Annals of Oncology

Abstract

BACKGROUND: High tumor mutational burden (TMB-H) is correlated with enhanced objective response rate (ORR) and progression-free survival (PFS) for certain cancers receiving immunotherapy. This study aimed to investigate the safety and efficacy of toripalimab, a humanized programmed death-1 (PD-1) antibody, in advanced gastric cancer (AGC), and the predictive survival benefit of TMB and PD-L1. PATIENTS AND METHODS: We reported on the AGC cohort of phase Ib/II trial evaluating the safety and activity of toripalimab in patients with AGC, oesophageal squamous cell carcinoma, nasopharyngeal carcinoma and head and neck squamous cell carcinoma. In cohort 1, 58 chemo-refractory AGC patients received toripalimab (3 mg/kg d1, Q2W) as a monotherapy. In cohort 2, 18 chemotherapy-naive AGC patients received toripalimab (360 mg d1, Q3W) with oxaliplatin 130 mg/m2 qd, d1, capecitabine 1000 mg/m2 b.i.d., d1-d14, Q3W as first-line treatment. Primary end point was ORR. Biomarkers such as PD-L1 and TMB were evaluated for correlation with clinical efficacy. RESULTS: In cohort 1, the ORR was 12.1% and the disease control rate (DCR) was 39.7%. Median PFS was 1.9 months and median OS was 4.8 months. The TMB-H group showed significant superior OS than the TMB-L group [14.6 versus 4.0 months, HR = 0.48 (96% CI 0.24-0.96), P = 0.038], while PD-L1 overexpression did not correlate with significant survival benefit. A 77.6% of patients experienced at least one treatment-related adverse event (TRAE), and 22.4% of patients experienced a grade 3 or higher TRAE. In cohort 2, the ORR was 66.7% and the DCR was 88.9%. A 94.4% of patients experienced at least one TRAE and 38.9% of patients experienced grade 3 or higher TRAEs. CONCLUSIONS: Toripalimab has demonstrated a manageable safety profile and promising antitumor activity in AGC patients, especially in combination with XELOX. High TMB may be a predictive marker for OS of AGC patients receiving toripalimab as a single agent. TRIAL REGISTRATION: ClinicalTrials.gov NCT02915432.

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Authors
Wang, F., Wei, X. L., Wang, F. H., Xu, N., Shen, L., Dai, G. H., Yuan, X. L., Chen, Y., Yang, S. J., Shi, J. H., Hu, X. C., Lin, X. Y., Zhang, Q. Y., Feng, J. F., Ba, Y., Liu, Y. P., Li, W., Shu, Y. Q., Jiang, Y., Li, Q., Wang, J. W., Wu, H., Feng, H., Yao, S., & Xu, R. H.
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2019-09
Volume
30
Issue
9
Pages
1479-1486
ISSN
0923-7534 (ISSN-L)
OpenAlex
W2954094199
Cited by
455
References
19
FWCI
21.58
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Safety, efficacy and tumor mutational burden as a biomarker of overall survival benefit in chemo-refractory gastric cancer treated with toripalimab, a PD-1 antibody in phase Ib/II clinical trial NCT02915432. https://app.cochat.ai/papers/10.1093/annonc/mdz197
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Wang, F., Wei, X. L., Wang, F. H., Xu, N., Shen, L., Dai, G. H., Yuan, X. L., Chen, Y., Yang, S. J., Shi, J. H., Hu, X. C., Lin, X. Y., Zhang, Q. Y., Feng, J. F., Ba, Y., Liu, Y. P., Li, W., Shu, Y. Q., Jiang, Y., . . . Xu, R. H. (2019). Safety, efficacy and tumor mutational burden as a biomarker of overall survival benefit in chemo-refractory gastric cancer treated with toripalimab, a PD-1 antibody in phase Ib/II clinical trial NCT02915432. Annals of Oncology. https://doi.org/10.1093/annonc/mdz197

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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