Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis

Abstract Chemotherapy serves as the primary therapeutic approach for triple-negative breast cancer (TNBC), yet its efficacy remains unsatisfactory. This study was a single-arm, open-label, single-center clinical trial (NCT05447702) involving patients with newly diagnosed stage II-III TNBC at West Ch...

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Main Authors: Xiaoxiao Liu, Chunying Zhuang, Lei Liu, Ling Xiong, Xin Xie, Ping He, Juanjuan Li, Bing Wei, Xi Yan, Tinglun Tian, Xiaorong Zhong, Jie Chen, Yan Cheng, Dan Zheng, Peng Cheng, Tianlin Sun, Weiwei Li, Changbin Zhu, Shuaitong Chen, Chao Fang, Jun Fu, Shibao Li, Jing Jing, Ting Luo
Format: Article
Language:English
Published: Nature Publishing Group 2025-07-01
Series:Signal Transduction and Targeted Therapy
Online Access:https://doi.org/10.1038/s41392-025-02337-1
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author Xiaoxiao Liu
Chunying Zhuang
Lei Liu
Ling Xiong
Xin Xie
Ping He
Juanjuan Li
Bing Wei
Xi Yan
Tinglun Tian
Xiaorong Zhong
Jie Chen
Yan Cheng
Dan Zheng
Peng Cheng
Tianlin Sun
Weiwei Li
Changbin Zhu
Shuaitong Chen
Chao Fang
Jun Fu
Shibao Li
Jing Jing
Ting Luo
author_facet Xiaoxiao Liu
Chunying Zhuang
Lei Liu
Ling Xiong
Xin Xie
Ping He
Juanjuan Li
Bing Wei
Xi Yan
Tinglun Tian
Xiaorong Zhong
Jie Chen
Yan Cheng
Dan Zheng
Peng Cheng
Tianlin Sun
Weiwei Li
Changbin Zhu
Shuaitong Chen
Chao Fang
Jun Fu
Shibao Li
Jing Jing
Ting Luo
author_sort Xiaoxiao Liu
collection DOAJ
description Abstract Chemotherapy serves as the primary therapeutic approach for triple-negative breast cancer (TNBC), yet its efficacy remains unsatisfactory. This study was a single-arm, open-label, single-center clinical trial (NCT05447702) involving patients with newly diagnosed stage II-III TNBC at West China Hospital. The treatment regimen consisted of camrelizumab (200 mg intravenously every 2 weeks, 12 cycles), apatinib (250 mg orally daily), and alternating chemotherapy [nab-paclitaxel (d1, 8, 15 every 4 weeks) for 4 cycles and epirubicin plus cyclophosphamide (every 2 weeks) for 4 cycles]. From June 2023 to April 2024, 35 patients were enrolled, of whom 1 patient withdrew due to adverse reaction intolerance. At treatment completion, the total pathological complete response (tpCR, ypT0/is, ypN0) rate was 67.6% (23/34), and the breast pCR (ypT0/is) rate was 70.6% (24/34). The overall response rate following neoadjuvant treatment reached 94.1% (32/34). Elevated levels of alanine aminotransferase (38.2%) and aspartate aminotransferase (29.4%) were the most common grade 3-4 adverse events, with no significant toxicities or treatment-related deaths reported. Comprehensive analysis of serum and tissue samples collected before and after neoadjuvant therapy via Olink and RNA sequencing revealed that the treatment induced a complex systemic immune response. These findings enabled the development of two novel scoring systems: a pretreatment response predictive score system for stratification and an efficacy assessment score system for treatment response evaluation. In conclusion, camrelizumab and apatinib combined with chemotherapy have good clinical efficacy and good safety as neoadjuvant treatments for stage II-III TNBC, warranting further investigation and potential clinical application.
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spelling doaj-art-f885c03ec1fb4a32b8a3eaa9ab3b8fb72025-08-20T04:02:45ZengNature Publishing GroupSignal Transduction and Targeted Therapy2059-36352025-07-0110111310.1038/s41392-025-02337-1Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysisXiaoxiao Liu0Chunying Zhuang1Lei Liu2Ling Xiong3Xin Xie4Ping He5Juanjuan Li6Bing Wei7Xi Yan8Tinglun Tian9Xiaorong Zhong10Jie Chen11Yan Cheng12Dan Zheng13Peng Cheng14Tianlin Sun15Weiwei Li16Changbin Zhu17Shuaitong Chen18Chao Fang19Jun Fu20Shibao Li21Jing Jing22Ting Luo23Institute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityDepartment of physiology, School of Basic Medical Sciences, Xuzhou Medical UniversityInstitute of Breast Health Medicine, West China Hospital, Sichuan UniversityDepartment of Radiation Oncology, Cancer Center, Affiliated Hospital of Xuzhou Medical University; Cancer Institute, Xuzhou Medical UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityDepartment of Radiation Oncology, Cancer Center, Affiliated Hospital of Xuzhou Medical University; Cancer Institute, Xuzhou Medical UniversityDepartment of Pathology, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityTranslational Medicine Department, Amoy Diagnostics Co., Ltd.Translational Medicine Department, Amoy Diagnostics Co., Ltd.Translational Medicine Department, Amoy Diagnostics Co., Ltd.Translational Medicine Department, Amoy Diagnostics Co., Ltd.LC-Bio Technology Co., Ltd.LC-Bio Technology Co., Ltd.LC-Bio Technology Co., Ltd.Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical UniversityInstitute of Breast Health Medicine, West China Hospital, Sichuan UniversityInstitute of Breast Health Medicine, Breast Center, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityAbstract Chemotherapy serves as the primary therapeutic approach for triple-negative breast cancer (TNBC), yet its efficacy remains unsatisfactory. This study was a single-arm, open-label, single-center clinical trial (NCT05447702) involving patients with newly diagnosed stage II-III TNBC at West China Hospital. The treatment regimen consisted of camrelizumab (200 mg intravenously every 2 weeks, 12 cycles), apatinib (250 mg orally daily), and alternating chemotherapy [nab-paclitaxel (d1, 8, 15 every 4 weeks) for 4 cycles and epirubicin plus cyclophosphamide (every 2 weeks) for 4 cycles]. From June 2023 to April 2024, 35 patients were enrolled, of whom 1 patient withdrew due to adverse reaction intolerance. At treatment completion, the total pathological complete response (tpCR, ypT0/is, ypN0) rate was 67.6% (23/34), and the breast pCR (ypT0/is) rate was 70.6% (24/34). The overall response rate following neoadjuvant treatment reached 94.1% (32/34). Elevated levels of alanine aminotransferase (38.2%) and aspartate aminotransferase (29.4%) were the most common grade 3-4 adverse events, with no significant toxicities or treatment-related deaths reported. Comprehensive analysis of serum and tissue samples collected before and after neoadjuvant therapy via Olink and RNA sequencing revealed that the treatment induced a complex systemic immune response. These findings enabled the development of two novel scoring systems: a pretreatment response predictive score system for stratification and an efficacy assessment score system for treatment response evaluation. In conclusion, camrelizumab and apatinib combined with chemotherapy have good clinical efficacy and good safety as neoadjuvant treatments for stage II-III TNBC, warranting further investigation and potential clinical application.https://doi.org/10.1038/s41392-025-02337-1
spellingShingle Xiaoxiao Liu
Chunying Zhuang
Lei Liu
Ling Xiong
Xin Xie
Ping He
Juanjuan Li
Bing Wei
Xi Yan
Tinglun Tian
Xiaorong Zhong
Jie Chen
Yan Cheng
Dan Zheng
Peng Cheng
Tianlin Sun
Weiwei Li
Changbin Zhu
Shuaitong Chen
Chao Fang
Jun Fu
Shibao Li
Jing Jing
Ting Luo
Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis
Signal Transduction and Targeted Therapy
title Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis
title_full Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis
title_fullStr Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis
title_full_unstemmed Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis
title_short Exploratory phase II trial of an anti-PD-1 antibody camrelizumab combined with a VEGFR-2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple-negative breast cancer (NeoPanDa03): efficacy, safety and biomarker analysis
title_sort exploratory phase ii trial of an anti pd 1 antibody camrelizumab combined with a vegfr 2 inhibitor apatinib and chemotherapy as a neoadjuvant therapy for triple negative breast cancer neopanda03 efficacy safety and biomarker analysis
url https://doi.org/10.1038/s41392-025-02337-1
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