Camrelizumab in combination with paclitaxel and cisplatin can become a new standard of first-line therapy in patients with advanced or metastatic esophageal cancer

Moscow, July 7, 2025 — New-generation checkpoint inhibitors can reduce mortality rates when used in patients with esophageal cancer^[1]. This disease is one of the most aggressive cancers and ranks eighth in the global mortality structure^[2]. Leading experts gathered at the Eastern Wind of Change in Immuno-Oncology and Combined Treatment Methods for Patients with Head and Neck Tumors symposia, held as part of the White Nights St. Petersburg International Oncology Forum, to discuss the use of immunotherapy in patients with difficult-to-treat cancers.

Thus, camrelizumab has advantages over other PD-L1/PD1 antagonist drugs with a similar mechanism of action. Particularly, camrelizumab does not decrease^[3] antitumor T cell counts, which helps maintain the dose of antibodies in the tumor and prevents hyperprogression. The affinity of camrelizumab for PD-1, glycosylated at N58, is 100 times higher^[4] than that of pembrolizumab. Selective and targeted binding allows for more efficient inactivation of the modified PD-1 protein, whose activity increases during the neoplastic process.

According to the ESCORT-1st study^[5] involving patients with squamous cell carcinoma of the esophagus who received camrelizumab as first-line therapy, the overall three-year survival doubled (to 25.6%), and two-year progression-free survival rates increased from 3.4% with chemotherapy to 20.4%. Another study, ESCORT, has demonstrated^[6] significant advantages of camrelizumab in second-line treatment of esophageal cancer compared to chemotherapy: the risk of progression and death decreased, median survival increased from 6.2 to 8.3 months and one-year overall survival reached 33.7% vs. 22.3%.

Nasopharyngeal cancer is another disease in which immunotherapy can significantly improve patient outcomes. This rare pathology often affects young people and is rarely detected in a timely manner: due to nonspecific symptoms such as nasal congestion, patients often seek help at later stages, said Svetlana Igorevna Kutukova. According to her, chemotherapy and radiation therapy are usually the options chosen to treat this disease, and immunotherapy is considered promising for advanced cases, particularly with the use of camrelizumab, which significantly improves progression-free survival rate in patients with nasopharyngeal cancer.

In the DIPPER study^[7] the use of camrelizumab in patients with nasopharyngeal cancer resulted in significant improvements in outcomes: the event-free survival increased to 86%, the risk of progression or death decreased by 44% and overall three-year survival exceeded 90%. These data were provided by Zamira Akhmedovna Radzhabova, Dr. habil. med., Head of the Department of Head and Neck Oncology at the National Medical Research Center of Oncology named after N.N. Petrov.

She noted that the Russian Society of Clinical Oncology (RUSSCO) has already included camrelizumab in combination with gemcitabine and cisplatin in its Practical Guidelines^[8] as the preferred first-line nasopharyngeal and esophageal cancer therapy^[9].

The number of studies demonstrating the efficacy of camrelizumab is constantly growing, which once again proves the importance of state-of-the-art treatment methods for improving the outcomes of patients with difficult-to-treat cancers.

The drug Areima^® (camrelizumab) was authorized in Russia by Petrovax Pharm in 2024 and will be manufactured on a full cycle basis after completion of the project to transfer the technology for synthesizing the substance, which is being implemented jointly with the N.F. Gamaleya NRCEM.