Evidence map›Paper›PMID 41121239›Full record

Trial reportBMC medicine2025

Lipid metabolism associated with efficacy of metronomic capecitabine and camrelizumab in gastrointestinal cancer: an exploratory clinical trial.

Chenfei Zhou, Yuanyuan Yin, Chengfang Shangguan, Qingqing Wu, Qu Cai, Wenqi Xi, Liting Guo, Jinling Jiang, Min Shi, Junwei Wu and 8 more

3 registry-linked trialsAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04508686 phase1unknown statusnot on this map

Phase 1 Trail to Observe Safety and Efficacy of Metronomic Capecitabine Plus PD-L1 Antibody Camrelizumab as Third-line Regimen to Treat HER2 Negative Advanced Gastric Cancer Patients

TypeinterventionalSponsorRuijin HospitalRan2020 to 2024Enrolled20ConditionsAdvanced Cervical CancerArmsCapecitabine, camrelizumab
NCT04510818 phase1unknown statusnot on this map

Phase 1 Trail to Observe Safety and Efficacy of Metronomic Capecitabine Plus Camrelizumab as Second-line Regimen to Treat Head and Neck Cancer or Esophageal Squamous Cancer Patients

TypeinterventionalSponsorRuijin HospitalRan2020 to 2024Enrolled20ConditionsHead and Neck Cancer, Esophageal Squamous CancerArmsCapecitabine, Camrelizumab
NCT04932187 phase1unknown statusnot on this map

Combination of Metronomic Capecitabine With Camrelizumab for Treatment of Refractory Solid Tumor (McCrest) Trial: Hepatobiliary, Pancreatic and Other Gastrointestinal Carcinoma (Non-stomach, Non-esophagi) (Cohort 3)

TypeinterventionalSponsorRuijin HospitalRan2021 to 2025Enrolled20ConditionsHepatobiliary, Pancreatic and Other Gastrointestinal Carcinoma (Non-stomach, Non-esophagi)ArmsCapecitabine, Camrelizumab
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Chenfei Zhou *Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yuanyuan Yin *Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, China.
Chengfang Shangguan *Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Qingqing WuCAS Key Laboratory of Systems Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China.
Qu CaiDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Wenqi XiDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Liting GuoDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jinling JiangDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Min ShiDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Junwei WuDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jun JiShanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xuekun ZhangDepartment of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yan SunDepartment of Surgery, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
Sander S M RensenDepartment of Surgery, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
Steven W M Olde DaminkDepartment of Surgery, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
Zhenggang ZhuDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Rong ZengShanghai Clinical Research and Trial Center, ShanghaiTech University, Shanghai, China. zengrong@shanghaitech.edu.cn.
Jun ZhangDepartment of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. junzhang10977@sjtu.edu.cn.

Funding

National Natural Science Foundation of China 82273126National Natural Science Foundation of China 92253304Shanghai Municipal Health Bureau Project 2020CXJQ03State Scholarship Fund of China Scholarship Council No. 202206235017
6 · The paper itself

Abstract

backgroundMetronomic chemotherapy shows potential to enhance efficacy of PD-1 antibodies but has not been assessed in gastrointestinal (GI) cancer. Immunotherapy efficacy can be affected by body composition and lipid metabolism of patients. We aimed to evaluate the feasibility of metronomic capecitabine plus camrelizumab as a salvage treatment of late-stage GI cancer and to explore the roles of body composition and lipid metabolism in this regimen.

methodsThis is a single-center, exploratory trial. Eligible GI cancer patients who had disease progression after standard chemotherapy were treated with metronomic capecitabine (500 mg twice daily) plus camrelizumab (200 mg on day 1 intravenously every 2 weeks). The primary endpoint was safety. Body composition indices analyzed by SliceOmatic software and lipidomics analyses using liquid chromatography-mass spectrometry were performed as exploratory investigation. Differentially expressed genes (DEGs) of C2C12 myocytes treated with metronomic dose 5-fluorouracil were detected by RNA sequencing.

resultsA total of 26 patients were enrolled. Treatment emergent adverse events (TEAEs) grade ≥ 3 occurred in five patients (19.2%). Objective response rate was 19.2% (5/26), including two patients with complete response. High skeletal muscle radiation attenuation (SMRA) was associated with disease control and better survival. Differential plasma lipids were identified in disease-controlled patients compared with those who showed disease progression. High levels of a 6-lipid signature composed of SM40:1;3, TG54:4-FA20:2, LPC(16:0), TG52:0-FA20:0, TG56:3-FA20:2, and PE(P-18:1/18:2) were associated with better survival. SMRA and this plasma lipid panel were both increased in disease-controlled patients after treatment. DEGs including prkg1, adora1, and Il15 in metronomic 5-FU treated C2C12 myocytes could be enriched into lipid metabolism pathways.

conclusionsMetronomic capecitabine plus camrelizumab is well tolerated and shows promising efficacy in GI cancer. SMRA and specific plasma lipids are associated with efficacy of this regimen and indicate the modulation effect of metronomic capecitabine on lipid metabolism. TRIAL REGISTRATIONS: NCT04508686 (Aug 11, 2020), NCT04510818 (Aug 12, 2020), NCT04932187 (Sep 17, 2021).

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCapecitabineGastrointestinal NeoplasmsLipid MetabolismAdministration, MetronomicAdultAgedBody CompositionFemaleHumansMaleMiddle AgedAntibodies, Monoclonal, HumanizedcamrelizumabCapecitabineCamrelizumabGastrointestinal cancerLipid metabolismMetronomic chemotherapy

Identifiers

PMID41121239
PMCPMC12538796

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.