The effect of the timing of camrelizumab intervention on the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable non-small cell lung cancer undergoing radiotherapy

Xiong Liang; Zhang Ning; Yu Yang; Zhao Ting; Han Zhiguo; Cheng Ailing

doi:10.3760/j.issn.1673-4777.2026.01.004

Abstract：Objective To investigate the effect of the timing of camrelizumab intervention on the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable non-small cell lung cancer(NSCLC)undergoing radiotherapy.Methods A total of 140 patients with NSCLC treated with concurrent chemoradiotherapy(carboplatin,pemetrexed and camrelizumab)in Shandong Provincial General Hospital of the Chinese People's Armed Police Force from January 2018 to February 2020 were retrospectively selected.According to the timing of camrelizumab intervention,the patients were divided into the control group and the observation group,with 70 cases in each group.The control group was treated with camrelizumab from days 42 to 60 after radiotherapy.The observation group received camrelizumab from day 1 to 21 after the end of radiotherapy.The tumor response rate,immune function,overall survival,progression-free survival and adverse reactions were compared between the two groups.Results After 2 cycles of treatment,there were significant differences in partial response rate,disease progression rate and objective response rate between the two groups(all P＜0.05).After 4 cycles of treatment,there were significant differences in the complete remission rate,stable disease rate and objective response rate between the two groups(all P＜0.05).After 2 and 4 cycles of treatment,the CD4+and CD4+/CD8+ratio of the two groups showed an upward trend,and those of the observation group were higher than those of the control group at each time point.The CD8+in the two groups showed a downward trend,and those of the observation group were lower than those of the control group at each time point(all P＜0.05).After 4 cycles of treatment,the expression levels of natural killer cells in the two groups were higher than those before treatment;after 2 cycles of treatment,those in the observation group were higher than those in the control group(all P＜0.05).After 48 months of follow-up,the overall survival and progression-free survival of the observation group were longer than those of the control group[(37±4)months vs(29±6)months,(31±3)months vs(24±4)months](all P＜0.001).Kaplan-Meier survival curve showed that the cumulative survival rate of the observation group was higher than that of the control group(Log-rank x2=24.873,P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Camrelizumab can improve the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable NSCLC after radiotherapy.