Abstract CT011: Penpulimab versus placebo in combination with chemotherapy as first-line treatment for recurrent or metastatic nasopharyngeal carcinoma: A global, multicenter, randomized, double-blind, phase 3 trial (AK105-304)
Bibliographic record
Abstract
Abstract Background: Studies have shown that the combination of PD-1 inhibitors with chemotherapy exhibits promising efficacy as a first-line treatment for Asian patients with recurrent or metastatic nasopharyngeal carcinoma (R/M NPC). This presentation reports the results of a global phase 3 clinical trial with ethnically diverse patients treated with penpulimab plus chemotherapy vs. placebo plus chemotherapy as the first-line therapy for R/M NPC (NCT04974398). Methods: AK105-304 trial was conducted across 46 sites worldwide. Participants aged 18-75 years with previously non-systemically treated R/M NPC, stratified by disease stages (de novo metastases vs. recurrent), ECOG (0 vs. 1), liver metastasis (present vs. absent), were randomized (1:1) to receive penpulimab or placebo (200mg, Day1) in combination with gemcitabine (1000mg/m2, Day 1 and 8) and cisplatin (80mg/m2, Day1) or carboplatin (AUC5, Day1) every 3 weeks (Q3W) for up to 6 cycles, followed by maintenance therapy with penpulimab or placebo (200mg, Q3W). Placebo-arm patients were allowed to crossover to receive penpulimab monotherapy (200 mg, Q3W) upon confirmed disease progression by blinded independent center review (BICR). Primary endpoint was PFS assessed by BICR, and key secondary endpoint was OS. Other secondary endpoints included ORR, DoR and safety. Results: 291 patients were randomized to penpulimab arm (n=144) or placebo arm (n=147). Baseline characteristics were generally balanced between treatment arms. By April 29, 2024, median follow-up time was 19.1 months. Per BICR assessment, median PFS was 9.6 months (95% CI: 7.1, 12.5) and 7.0 months (95% CI: 6.9, 7.3), respectively, for penpulimab+chemo and placebo+chemo (HR=0.45, 95% CI: 0.33, 0.62, two-sided P < 0.0001). Confirmed ORR was 68.1% vs. 63.9%, and median DoR was 9.8 months (95% CI: 7.0, 17.5) vs. 5.7 months (95% CI: 5.5, 6.7) (HR=0.4, 95%CI: 0.27, 0.59). OS was not mature, with 48 deaths in penpulimab arm and 49 in placebo arm (HR=0.94, 95% CI: 0.63, 1.40). After adjusting for crossover of patients from placebo to penpulimab upon PD, OS benefit became more evident, with HR of 0.62 (0.41, 0.94) by Rank Preserving Structural Failure Time (RPSFT) model, 0.75 (0.43, 1.30) by Inverse Probability of Censoring Weighting (IPCW) method, and 0.78 (0.52, 1.17) by two-stage Accelerated Failure Time (AFT) model. The incidence of Grade ≥3 TRAEs was 89.0% vs. 85.9%; SAEs was 50.7% vs. 48.6%; irAEs was 30.8% vs. 8.5%; Grade ≥3 irAEs was 4.1% vs. 0. Conclusions: Penpulimab combined with gemcitabine and cisplatin or carboplatin demonstrated statistically significant and clinically meaningful benefit with a manageable safety profile, and provides a new beneficial treatment option in the first-line treatment for R/M NPC patients globally. Citation Format: Chaosu Hu, Xiaozhong Chen, Tingting Xu, 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, Jiyu Wen, Jian Zhang, Qin Lin, Xiaojiang Li, Kangsheng Gu, Li Xiang, Dongxia Wang, Jingao Li, 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, Dongmei Lu, Mingxiu Hu, Zhongmin Maxwell Wang, Baiyong Li, Michelle Xia. Penpulimab versus placebo in combination with chemotherapy as first-line treatment for recurrent or metastatic nasopharyngeal carcinoma: A global, multicenter, randomized, double-blind, phase 3 trial (AK105-304) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_2):Abstract nr CT011.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".