Does camrelizumab carry a higher progression risk than pembrolizumab in non-squamous non-small cell lung cancer?
For non-squamous non-small cell lung cancer (nsNSCLC), several PD-1 inhibitors are available, but direct comparisons are limited. A real-world study found that camrelizumab was associated with a higher risk of disease progression and death compared to pembrolizumab, particularly when used as second or later-line therapy 8. This suggests that pembrolizumab may be a more effective option in this setting, though individual factors matter.
What the research says
A real-world retrospective study directly compared four PD-1 inhibitors (pembrolizumab, sintilimab, tislelizumab, and camrelizumab) in 409 patients with advanced NSCLC 8. For the nonsquamous NSCLC subgroup, camrelizumab given as second or later-line treatment was linked to a significantly higher risk of disease progression (hazard ratio [HR] 2.29; 95% CI 1.01-5.19) and death (HR 3.14; 95% CI 1.28-7.74) compared to pembrolizumab 8. Objective response rates were similar among the drugs, but the progression and survival risks were worse with camrelizumab 8. These findings come from a real-world setting, not a randomized trial, so they should be interpreted with caution. In contrast, pembrolizumab has strong evidence from randomized trials showing improved overall survival versus chemotherapy in advanced NSCLC with high PD-L1 expression 35. A network meta-analysis of first-line therapies for nsNSCLC found that pembrolizumab plus chemotherapy ranked among the best for overall survival 6. However, that analysis did not include camrelizumab, so direct comparisons from randomized data are lacking 6.
What to ask your doctor
- What is the evidence for camrelizumab versus pembrolizumab in my specific type of non-squamous NSCLC?
- Given my PD-L1 expression level, which PD-1 inhibitor might offer the best balance of effectiveness and side effects?
- If I am considering second-line treatment, how do the risks of progression and survival compare between camrelizumab and pembrolizumab?
- Are there any ongoing clinical trials directly comparing these two drugs in non-squamous NSCLC?
- How do the side effect profiles of camrelizumab and pembrolizumab differ, and which might be better for my overall health?
This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.