Camrelizumab Plus Apatinib Demonstrates Promise in Advanced or Refractory Chordoma

According to results from an investigator-initiated phase 2 trial, camrelizumab plus apatinib demonstrated promising efficacy and safety among patients with advanced or refractory chordoma. 

These data were first presented by Cheng Yang, MD, Changzheng Hospital, Navy Medical University, Shanghai, China, at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois. 

In this open-label, single-arm study, 33 patients received 200 mg of camrelizumab once every 2 weeks plus either 250 mg or 500 mg of once daily apatinib in 28-day cycles. The primary end point was objective response rate (ORR). Key secondary end points included disease control rate, progression-free survival (PFS), and safety. Predictive biomarker analyses were performed using next-generation sequencing (n = 20) and fluorescence in situ hybridization (FISH, n = 25). 

At a median follow-up of 15 months, the median treatment duration was 7 months and 45.5% of patients remained on study treatment. As assessed by RECIST 1.1 criteria, 7 patients achieved partial response, with a 6-month disease control rate of 85.2% and a median PFS of 18.1 months. As assessed by Choi criteria, 16 patients achieved partial response, with a 6-month disease control rate of 77.7% and a median PFS of 15.3 months. 

Any grade adverse events occurred in 93.9% of patients and grade 3/4 adverse events occurred in 48.5% of patients. Treatment-related adverse events led to camrelizumab dose interruptions in 21.2% of patients and apatinib dose interruptions in 39.4% of patients. Four deaths occurred due to tumor progression (n = 2) and postoperative cervical recurrent chordoma complications (n = 2). 

Post hoc analyses revealed a copy number deletion on CDKN2A in 30% of patients via next-generation sequencing and a homozygous deletion on CDKN2A in 40% via FISH, which was correlated with poorer outcomes. 

“The combination of camrelizumab and apatinib demonstrated promising efficacy and manageable toxicity in chordoma treatment,” concluded Dr Yang et al. “Furthermore, CDKN2A alterations (CND or HD) were associated with poorer outcomes, providing a potential biomarker for therapeutic stratification.”

Source: 

Yang C, Jia Q, Zhao C, et al. Camrelizumab plus apatinib in patients with advanced or refractory chordoma: A single-arm, open-label, phase 2 trial. Presented at 2025 ASCO Annual Meeting. May 30-June 3, 2025; Chicago, IL. Abstract 11503