Anti-PD-1 antibody penpulimab plus chemotherapy for recurrent or metastatic nasopharyngeal carcinoma: a randomized, double-blind phase 3 study

作者：Shuang Huang, Feng Liu, Song Qu, Lisha Chen, Ping Zhou, Shenhong Qu, Xiaohong Ai, Yong Chen, Meilian Liu, Rensheng Wang, Kelvin KW Chan, Peng Zhang, Chunhong Hu, Chunhong Hu, Jiyu Wen, Jian Zhang, Xiaojiang Li, Xiaojiang Li, Kangsheng Gu, Xiang Li, Dongxia Wang, Daren Lin, Daren Lin, Desheng Hu, Jianwu Ding, Siyang Wang, Xiaoming Huang, Lin Wang, Feng Jin, David G. Pfister, Milena Perez Mak, Pedro Rafael Martins De Marchi, Yi Jiang, Haihua Yang, Xiaoye Hu, Tianrun Liu, Dehua Wu, Aditya Shreenivas, Thiago Bueno de Oliveira, Carlos Eduardo Baston Silva, Gustavo Vasconcelos Alves, Xianming Li, Zhifang Yao, Mingxiu Hu, Mingxiu Hu, Zhongmin Maxwell Wang, Baiyong Li, Michelle Xia, Xiaozhong Chen, Tingting Xu, Chaosu Hu, Tingting Xu · 发表于：Signal Transduction and Targeted Therapy · 年份：2026 · DOI：10.1038/s41392-026-02645-0 · 被引用次数：3 · 研究领域：Head and Neck Cancer Studies、Cancer Immunotherapy and Biomarkers、Colorectal and Anal Carcinomas

In this phase 3 trial, penpulimab combined with chemotherapy was assessed against a regimen of placebo plus chemotherapy for the first-line treatment of recurrent or metastatic nasopharyngeal carcinoma (R/M NPC). 291 patients were randomised and allocated in a 1:1 ratio in order to receive penpulimab (n = 144; 200 mg) or placebo (n = 147; 200 mg), plus chemotherapy (cisplatin/carboplatin and gemcitabine) every 3 weeks. Patients followed by maintenance therapy with penpulimab or placebo after 6 cycles. The primary endpoint of this study was progression-free survival (PFS) according to RECIST v1.1, and a significantly longer median PFS in the penpulimab arm versus the placebo arm (9.63 versus 7.00 months; hazard ratio 0.45, 95% CI: 0.33-0.62, P < 0.0001) was demonstrated in this prespecified interim analysis. The key secondary endpoint was the overall survival (OS). However, the OS data were still immature, and the median OS was not achieved (hazard ratio, 0.94; 95% CI: 0.63-1.40). The occurrence of treatment-related adverse events (grade ≥ 3) was 89.0% and 85.9% in two arms, with the most common being reduced the quantity of neutrophil (56.2% vs. 62.0%), reduced the quantity of white blood cell (54.1% vs. 54.9%), and anemia (45.2% vs. 38.7%). In the penpulimab arm, 6 patients (4.1%) experienced immune-related adverse events (grade ≥ 3). Adding penpulimab to chemotherapy led to a notable enhancement in PFS for the first-line R/M NPC treatment, alongside a safety profile that wa...