Study of vedicetuzumab combined with carrilizumab in the treatment of human epidermal growth factor receptor 2-positive advanced gastric cancer

LEI Kai; QI Yabin; JIN Lei; ZHANG Xiaozhao

doi:10.3969/j.issn.1674-4136.2025.01.006

Abstract：Objective To observe the efficacy and safety of vedicetuzumab combined with carrilizumab in the treatment of human epidermal growth factor receptor(HER)2-positive advanced gastric cancer.Methods Patients with HER-2-positive advanced gastric cancer admitted to the Department of General Surgery of Xi'an Ninth Hospital from April 2020 to May 2023 were divided into control group and experimental group according to the random number table method.Both groups took S-1 capsule 40 mg/m2 orally,twice a day,2 weeks before each cycle;Oxaliplatin 130 mg/m2 was given intravenously on day 1;3 weeks for 1 cycle,treatment for 2 cycles.The control group was also given 200 mg carrilizumab intravenously,once every 3 weeks.The experimental group was additionally given intravenously with vedicetuzumab,2.5 mg/kg each time,once every 2 weeks.Two groups were treated for 4 cycles to evaluate the therapeutic effect and followed up for 1 year.The antitumor efficacy,tumor markers,immune function,adverse drug reactions and survival status of the two groups were compared.Results 71 cases were included in the experimental group and 70 cases in the control group.The objective remission rates of the experimental group and the control group were 36.62％(26 cases/71 cases)and 21.43％(15 cases/70 cases),respectively,and the clinical control rates were 77.46％(55 cases/71 cases)and 61.43％(43 cases/70 cases),respectively,with a statistically significant difference(P＜0.05).After treatment,the carcinoembryonic antigen of experimental group and control group were(22.91±3.48)and(26.87±4.01)ng/L,and the squamous cell carcinoma antigen were(19.86±3.12)and(23.14±3.89)ng/L,cell proliferation antigen was(297.14±37.61),(324.83±41.28)ng/mL,Thl/Th2 was(4.91±0.52),(5.28±0.64),CD4+/CD8+was(1.49±0.23),(1.27±0.19),respectively,and the difference was statistically significant(P＜0.05).The total incidence of adverse drug reactions in the experimental group and the control group was 38.03％(27 cases/71 cases)and 34.29％(24 cases/70 cases),respectively,with no statistical significance(P＞0.05).After 1 year of follow-up,there was no medical record dropout in either group.The median progression-free survival was 6(5.2,6.8)months in the experimental group and 8(7.6,8.4)months in the control group,and there was a statistically significant difference between the groups(P＜0.001).There were 19 deaths in the experimental group and 28 deaths in the control group,and there were statistically significant differences in the overall survival curves between the two groups(P=0.032),and the hazard ratio HR=0.439(95％CI:0.347-0.612).Conclusions Vedicetuzumab combined with carrilizumab in the treatment of HER2-positive advanced gastric cancer can enhance anti-tumor efficacy,improve immune function and have good safety.