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Updated: Oct 9, 2025
Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
Camrelizumab: an investigational agent for hepatocellular carcinoma
1Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Introduction:
Although many approaches have been used to treat hepatocellular carcinoma (HCC), the clinical benefits were limited, particularly for advanced HCC. However, recent treatments with PD-1/PD-L1 inhibitor monotherapy and its combination with other therapies, have demonstrated remarkable results. Camrelizumab, a selective, humanized, high-affinity IgG4 PD-1 monoclonal antibody, has been approved as a second-line treatment in patients with advanced HCC by NMPA in China.
Areas Covered:
This paper introduces anti-PD-1/PD-L1 immunotherapies for advanced HCC and progresses to discuss the pharmacology, safety, and efficacy of camrelizumab in the treatment of advanced HCC. It also considers future research directions for camrelizumab in this setting.
Expert Opinion:
The PD-1 binding epitope of camrelizumab is different from other PD-1 inhibitors. The IC50 and EC50 of camrelizumab for inhibiting the binding of PD-1 and PD-L1 is similar to pembrolizumab, is significantly lower than other PD-1 inhibitors, and has a higher affinity for PD-1 site. Camrelizumab exhibits a promising antitumor activity and an acceptable safety profile similar to other PD-1 inhibitors in advanced HCC. Apatinib (a VEGFR-2 tyrosine kinase inhibitor) can reduce the incidence of camrelizumab-specific reactive cutaneous capillary endothelial proliferation (RCCEP).
Insights
Camrelizumab, a PD-1 inhibitor, shows promising antitumor activity and an acceptable safety profile for advanced hepatocellular carcinoma (HCC). Its unique binding epitope and high affinity offer potential advantages in treating this challenging cancer.
Area of Science:
- Immunotherapy
- Oncology
- Hepatocellular Carcinoma Research
Background:
- Hepatocellular carcinoma (HCC) treatments have limited clinical benefits, especially for advanced stages.
- Immune checkpoint inhibitors, such as PD-1/PD-L1 inhibitors, have shown remarkable results in advanced HCC.
- Camrelizumab, a selective PD-1 monoclonal antibody, is approved in China for advanced HCC.
Purpose of the Study:
- To review anti-PD-1/PD-L1 immunotherapies for advanced HCC.
- To discuss the pharmacology, safety, and efficacy of camrelizumab in advanced HCC.
- To explore future research directions for camrelizumab in HCC treatment.
Main Methods:
- Review of existing literature on PD-1/PD-L1 inhibitors in HCC.
- Pharmacological analysis of camrelizumab.
- Evaluation of safety and efficacy data for camrelizumab.
Main Results:
- Camrelizumab has a distinct PD-1 binding epitope compared to other PD-1 inhibitors.
- Its IC50 and EC50 values are comparable to pembrolizumab and lower than other PD-1 inhibitors, indicating higher affinity.
- Camrelizumab demonstrates promising antitumor activity and an acceptable safety profile in advanced HCC.
Conclusions:
- Camrelizumab exhibits favorable pharmacological properties and clinical potential in advanced HCC.
- Combination therapy with apatinib may mitigate camrelizumab-specific side effects like RCCEP.
- Further research is warranted to optimize camrelizumab's role in HCC treatment.
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