Camrelizumab (AiRuiKa)
A humanized anti-PD-1 immunotherapy for hepatocellular carcinoma, esophageal cancer, lung cancer, and Hodgkin lymphoma.
What is Camrelizumab?
What it targets
The PD-1 receptor on T cells, blocking interaction with PD-L1 and PD-L2 ligands on cancer cells and restoring immune-mediated anti-cancer attack.
Who it may help
Patients with HCC, esophageal cancer, lung cancer, Hodgkin lymphoma, nasopharyngeal cancer, and other approved cancers.
Why testing matters
Baseline liver, kidney, thyroid tests and hepatitis B, C, HIV, TB screening are essential before starting treatment.
Which cancers can Camrelizumab treat?
Camrelizumab is approved or used in the following cancers in China and under clinical evaluation or pending approval in other countries.
| Hepatocellular Carcinoma (HCC, second-line) | Approved as monotherapy for HCC in patients who have failed or are ineligible for first-line therapy. Combination with apatinib/rivoceranib shows improved outcomes and is pending FDA approval for first-line use. |
| Esophageal Squamous Cell Carcinoma (ESCC) | Approved for second-line treatment of advanced ESCC after chemotherapy failure. ESCORT-1st trial showed significantly improved progression-free and overall survival compared to chemotherapy alone. |
| Non-Small Cell Lung Cancer (NSCLC) | Approved in combination with chemotherapy as first-line treatment for advanced squamous and non-squamous NSCLC. CameL trials demonstrated survival benefit in chemotherapy-naive patients. |
| Classical Hodgkin Lymphoma (cHL) | Approved for relapsed or refractory cHL after prior systemic therapy. Showed objective response rates exceeding 75% in heavily pre-treated patients with limited other options. |
| Nasopharyngeal Carcinoma (NPC) | Approved in combination with gemcitabine and cisplatin as first-line treatment for recurrent or metastatic NPC. CAPTAIN-1st trial demonstrated improved outcomes versus chemotherapy alone. |
Are you eligible for Camrelizumab?
Eligibility depends on cancer type, disease stage, treatment history, organ function, and baseline health status.
- Confirmed cancer diagnosis by biopsy with pathology and staging by imaging (CT, MRI, PET-CT).
- Adequate liver function (bilirubin, AST/ALT) - especially important as HCC patients often have cirrhosis.
- Adequate kidney function (creatinine, estimated GFR within acceptable limits).
- Adequate blood counts (white cells, platelets) - baseline bone marrow function required.
- No active or uncontrolled autoimmune disease, recent organ transplant, or chronic immunosuppressive therapy.
- No pregnancy; effective contraception required throughout treatment for reproductive-aged patients.
How does Camrelizumab work?
- Blocking PD-1 on T cells
- Restoring immune attack
- Sustained immune response
- Combination synergy
Camrelizumab is one of the first Chinese-developed checkpoint inhibitors to achieve approval across multiple advanced cancers.
Tests required before starting Camrelizumab
These tests confirm your suitability for treatment, establish baselines to monitor for toxicity, and help guide dosing decisions.
| Biopsy and histopathology | Confirms cancer type and stage. Determines which camrelizumab indication applies and whether you meet entry criteria. |
| Baseline imaging (CT, MRI, PET-CT) | Establishes tumour burden, location, and extent. Repeat imaging every 8-12 weeks during treatment to assess response. |
| Complete Blood Count (CBC) | Establishes baseline white cells, platelets, and haemoglobin. Monitored every 3-4 weeks to detect bone marrow toxicity. |
| Liver function tests (bilirubin, AST, ALT, albumin) | Critical as HCC patients often have cirrhosis. Low baseline values may limit dosing. Monitored every 3-4 weeks. |
| Kidney function tests (creatinine, GFR) | Baseline creatinine and calculated GFR needed for safety. Monitored every 3-4 weeks as immune-mediated glomerulonephritis can occur. |
| Thyroid function tests (TSH, free T4) | Baseline thyroid status essential as immune-related hypothyroidism and hyperthyroidism are common. Monitored every 6-8 weeks. |
How is Camrelizumab given?
Camrelizumab is given as an intravenous (IV) infusion in a hospital, cancer centre, or specialist infusion clinic. Treatment schedules vary depending on cancer type and whether it is combined with other drugs.
| Standard monotherapy dose | 200 mg IV infusion over 30-60 minutes, given once every 3 weeks (21-day cycle). |
| Dose in combination therapy | 200 mg IV with chemotherapy: infused on day 1 of each 3-week cycle. With apatinib/rivoceranib: 200 mg IV every 3 weeks alongside daily oral anti-angiogenic agent. |
| Infusion procedure | Infusion is given in a medical setting by trained staff. Vital signs monitored before and during infusion. Most patients go home the same day (outpatient basis). |
| Premedication | Antihistamines and paracetamol often given before infusion to reduce infusion reactions. Your centre will advise on specifics. |
| Missed or delayed doses | If you miss an infusion, contact your oncology team immediately. Do not double-dose. Reschedule as soon as possible to minimise gaps. |
| Duration of treatment | Treatment typically continues until disease progression, unmanageable side effects, or after 12-24 months if there is sustained response. Your oncologist will discuss stopping criteria with you. |
Clinical evidence and benefits
Camrelizumab has demonstrated meaningful clinical benefit across multiple advanced cancer types in well-conducted trials.
| HCC: Improved survival with combination | CARES-310 trial: camrelizumab + rivoceranib showed median overall survival of 23.8 months vs 15.2 months with sorafenib (HR 0.64). Progression-free survival median 5.6 vs 3.7 months. |
| ESCC: Second-line survival benefit | ESCORT-1st trial: camrelizumab + chemotherapy significantly extended overall survival and progression-free survival compared to chemotherapy alone in advanced ESCC. |
| NSCLC: First-line improvement | CameL trials showed camrelizumab + chemotherapy improved response rates and survival compared to chemotherapy alone in treatment-naive advanced NSCLC patients. |
| Hodgkin lymphoma: High response rates | Over 75% objective response rate in relapsed or refractory classical Hodgkin lymphoma after multiple prior treatments, with durable responses in heavily pre-treated patients. |
| Quality of life | Immunotherapy generally has fewer acute toxicities than chemotherapy. Most patients maintain reasonable functional status and outpatient treatment allows continuation of daily activities. |
Clinical responses vary widely between individuals. These represent published trial data and do not guarantee individual outcomes. Your oncologist will discuss realistic expectations based on your specific cancer and health status.
Side effects of Camrelizumab
As an immunotherapy, camrelizumab works by activating your immune system. Most side effects are immune-related and different from chemotherapy toxicity. While serious side effects can occur, they are usually manageable with prompt recognition and treatment.
| Fatigue or weakness | Very common; often improves over time. Manage with rest, light activity, and good nutrition. Report persistent worsening. |
| Fever | Common early in treatment. Usually low-grade and self-limiting. Fever >38.5°C or fever lasting >48 hours requires urgent medical evaluation. |
| Rash or itching | Mild to moderate skin reactions are common. Often managed topically or with antihistamines. Report spreading rash or severe itching. |
| Reactive cutaneous capillary proliferation (RCCEP) | Unique to camrelizumab: red, raised skin lesions appearing like cherry hemangiomas. Most are painless or mildly itchy. Usually manageable; respond to topical treatment or dose adjustments. |
| Hypothyroidism or thyroid changes | Common immune-related effect. TSH monitoring essential. Hypothyroidism managed with levothyroxine replacement. Usually develops during or shortly after treatment. |
| Nausea, reduced appetite, diarrhea | Mild to moderate GI effects in 20-30% of patients. Manage with antiemetics, dietary modification, and hydration. Severe diarrhea may signal immune colitis. |
| Cough or shortness of breath | Can signal immune-related pneumonitis, a serious condition requiring urgent evaluation. Seek immediate medical help if new or worsening respiratory symptoms develop. |
| Abnormal liver tests | Elevation of liver enzymes common, especially in HCC patients with cirrhosis. Close monitoring and dose adjustment may be needed. Severe elevation may require treatment interruption. |
Contact your doctor immediately if you develop:
- New or worsening shortness of breath, persistent cough, or chest pain (risk of immune pneumonitis).
- Severe diarrhea (>4 stools per day), abdominal pain, or bloody stools (risk of immune colitis).
- Yellowing of eyes or skin, right-sided abdominal pain, or severe nausea (risk of immune hepatitis).
- Unusual weakness, confusion, severe headache, or vision changes (risk of immune neurological effects).
- Severe rash, blistering, or rash spreading rapidly (risk of severe skin immune reaction).
- Fever >38.5°C, severe chills, or signs of infection (risk of opportunistic infection during immune activation).
Safety precautions and drug interactions
Tell your oncologist and pharmacist about all medicines, supplements, herbal products, and your medical history before starting camrelizumab. This helps prevent serious interactions and unsafe combinations.
- Autoimmune disease history (lupus, rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis): camrelizumab can flare autoimmune disease and may not be suitable.
- Organ transplant history (kidney, liver, heart, stem cell): immunotherapy can damage transplanted organs and generally avoided unless benefits clearly outweigh risks.
- Hepatitis B or C infection or cirrhosis: camrelizumab can reactivate hepatitis B or cause severe hepatitis. Regular monitoring and prophylactic antivirals may be needed.
- Tuberculosis (active or latent) or other chronic infections: TB reactivation under immunotherapy is a serious risk. Tuberculosis must be treated or excluded before starting camrelizumab.
- Lung disease (COPD, interstitial pneumonitis, history of pneumonitis): baseline lung function testing essential. Respiratory monitoring during treatment mandatory.
- Pregnancy: camrelizumab causes serious foetal harm (Category D). Effective contraception required throughout treatment. Do not breastfeed during treatment.
- Current immunosuppressive therapy (including systemic steroids): these can reduce camrelizumab effectiveness. Discuss with your oncologist before continuing.
Camrelizumab combination treatments
Camrelizumab is often combined with chemotherapy or anti-angiogenic drugs to improve efficacy in selected cancers. Combinations are tailored to cancer type and treatment setting.
| Camrelizumab + apatinib/rivoceranib (HCC) | First-line combination for unresectable HCC. CARES-310 showed superior survival to sorafenib. Currently pending FDA approval (decision July 2026). |
| Camrelizumab + chemotherapy (ESCC, NSCLC, NPC) | Combines immunotherapy with platinum/taxane chemotherapy in first or second-line settings. Improves response rates and overall survival compared to chemotherapy alone. |
| Switching options if resistance develops | If camrelizumab fails, options may include different immunotherapy combinations, targeted drugs (tyrosine kinase inhibitors, BRAF/MEK inhibitors), chemotherapy rechallenge, or clinical trials. |
| Monotherapy escalation | If monotherapy insufficient, adding second agent (chemo or targeted therapy) may improve response. Conversely, if combination too toxic, stepping down to monotherapy may be considered. |
If Camrelizumab stops working
Some patients develop resistance to camrelizumab and their cancer begins to grow despite treatment. Understanding resistance mechanisms helps guide next-line therapy.
| Primary resistance (no initial response) | Some patients show no tumour shrinkage from the start. Possible reasons include low PD-L1 expression, high tumour mutational burden threshold, presence of suppressive immune cells, or baseline poor performance status. |
| Secondary resistance (progression after response) | Cancer may develop adaptive immune escape by upregulating alternative checkpoint molecules (LAG-3, TIM-3, TIGIT), shifting to immune-cold phenotype, or selecting for resistant clones. |
| Genomic resistance mechanisms | In some cancers, specific mutations predict resistance (e.g. PTEN loss, STK11 alteration in NSCLC). Repeat biopsy and genomic testing can reveal mechanisms and guide next-line selection. |
| Next-line treatment options | Depends on cancer type and prior therapy. May include dual checkpoint inhibition (PD-1 + CTLA-4), switch to different PD-1 inhibitor, tyrosine kinase inhibitor, standard chemotherapy, locoregional therapy, or clinical trial enrollment. |
Cost of Camrelizumab by country
Camrelizumab pricing varies significantly by country, healthcare system, and whether generic alternatives are available.
| China | Estimated 15,000-25,000 RMB per 200 mg infusion (approximately USD 2,000-3,500). China national insurance may cover 40-70% depending on province and negotiated pricing. Multiple generic versions are not yet available but cost may decrease. |
| India | Camrelizumab is not yet licensed in India and availability is limited to private hospitals with access programs or clinical trials. Cost would likely be USD 1,500-3,000 per infusion if available. CancerFax can assist with access exploration. |
| USA | Once FDA-approved, estimated cost USD 4,000-6,000 per 200 mg infusion. Most US insurance plans will likely cover after prior authorisation. Copays depend on plan. Patient assistance programmes from the manufacturer may reduce out-of-pocket costs. |
| Europe | Pricing varies by country health system (Germany: EUR 2,500-3,500; UK: variable NHS negotiation; France: social security coverage). Costs depend on negotiated national prices and local insurance formularies. |
Availability of Camrelizumab globally
Camrelizumab is approved in China under multiple indications and under regulatory review in several other countries.
China
Approved by NMPA for 8 indications including HCC (second-line), ESCC (second-line), NSCLC (first-line with chemotherapy), Hodgkin lymphoma, and NPC. Available under brand name AiRuiKa at major cancer centres and hospitals.
USA
Under FDA review for unresectable hepatocellular carcinoma in combination with rivoceranib. PDUFA target action date July 23, 2026. Not yet approved or available as marketed drug. Clinical trial access may be possible.
India
Not yet licensed in India. Limited access through some private hospitals with international supply agreements or clinical trial enrollment. CancerFax can explore access pathways including possible trial opportunities.
Europe
Orphan drug designation granted for HCC but not approved. Under evaluation; regulatory pathway ongoing. Some European centres may have access through clinical trial participation or compassionate use programs.
Camrelizumab in current clinical trials
Over 50 clinical trials are currently underway evaluating camrelizumab in multiple cancers and treatment settings.
| FDA Phase 3 trials (HCC) | CARES-310 showed camrelizumab + rivoceranib superior to sorafenib. Now under FDA review with decision expected July 2026. Additional trials evaluating other indication combinations are ongoing. |
| Ongoing combination trials | Trials are evaluating camrelizumab combined with different chemotherapy regimens, anti-angiogenic agents, and other immunotherapies in NSCLC, gastric cancer, breast cancer, and melanoma. |
| Biomarker refinement studies | Research into PD-L1 expression, tumour mutational burden, immune infiltration patterns, and other biomarkers to identify which patients benefit most from camrelizumab across cancer types. |
| Global trial access | Many trials are conducted in China; some international sites in Asia and Australia. CancerFax can help identify trial eligibility and enrolment pathways if you are interested in clinical trial participation. |
Your treatment journey with Camrelizumab
Initial assessment and testing
Oncology consultation and eligibility confirmation
First infusion and baseline monitoring
Early monitoring phase (weeks 3-12)
Ongoing monitoring and response assessment
Decisions at progression or toxicity
Questions to ask your oncologist about Camrelizumab
- Is camrelizumab appropriate for my specific cancer type and stage?
- How long will I need to receive camrelizumab infusions?
- What is RCCEP and what should I do if I develop skin lesions?
- What are the serious immune-related side effects I should watch for?
- How will you monitor my liver, kidney, and thyroid function?
- If camrelizumab stops working, what are my next-line options?
- What is the total estimated cost including infusions, tests, and supportive care?
- Are there clinical trials I might be eligible for?
How CancerFax supports Camrelizumab patients
CancerFax helps cancer patients and families understand treatment options, navigate access, and connect with specialist expertise for complex cases.
| Report review and interpretation | Upload your pathology, imaging, and genetic test results. Our oncology team reviews them and explains what they mean for your treatment eligibility and prognosis with camrelizumab or alternative options. |
| Second opinion consultation | If unsure about whether camrelizumab is right for you or what to do if it stops working, CancerFax arranges expert second opinions from oncologists experienced with this drug across multiple cancer types. |
| China treatment access and coordination | For patients seeking camrelizumab in China where it is approved and established, CancerFax coordinates hospital selection, treatment planning, accommodation, translation, and follow-up communication with oncologists. |
| India and international access pathways | As camrelizumab is not yet licensed in India, CancerFax explores clinical trial access, compassionate use programs, or alternative approved immunotherapies suitable for your cancer type. |
| Cost and financial navigation | CancerFax clarifies expected costs across countries, helps identify patient assistance programs, insurance coverage, and affordable generic alternatives where available, so financial constraints don't block access to needed treatment. |
Frequently asked questions about Camrelizumab
Common questions from patients and caregivers
Camrelizumab is an immunotherapy that blocks PD-1, a checkpoint protein that cancers use to hide from the immune system. Unlike chemotherapy, which damages all fast-dividing cells, camrelizumab helps your own immune cells recognize and attack cancer. It is given as an IV infusion in a hospital or clinic, not taken at home like oral tablets.
Response timing varies by cancer type and combination therapy. In hepatocellular carcinoma, response is usually assessed at 8-12 weeks by imaging. In esophageal cancer and lung cancer, oncologists monitor you every 6-8 weeks. Some patients see benefit within weeks; others take longer. Your oncologist will explain your personal response milestones.
Camrelizumab can be combined with certain chemotherapy drugs, anti-angiogenic medicines like apatinib or rivoceranib, and other treatments depending on your cancer type. However, it may interact with immunosuppressants or other medicines. Tell your oncologist and pharmacist about all medicines, supplements, and herbal products you take before starting treatment.
RCCEP stands for reactive cutaneous capillary endothelial proliferation - a unique camrelizumab side effect that causes red, raised skin lesions that look like small capillaries or cherry hemangiomas. These lesions are usually manageable and improve with treatment adjustments or topical care. Report any new or changing skin lesions to your doctor immediately.
If your cancer grows while on camrelizumab, your oncologist will repeat imaging and may perform new biopsies or genetic tests to understand why. Next-line options depend on your cancer type and prior treatment but may include different immunotherapies, targeted drugs, chemotherapy, or clinical trials. A second opinion is often helpful for advanced or resistant disease.
Camrelizumab is currently approved in China under the brand name AiRuiKa for multiple cancer types. FDA approval for unresectable hepatocellular carcinoma (in combination with rivoceranib) is pending, with a decision expected July 2026. Availability in Europe, India, and other countries varies. CancerFax can help you explore access options and check current approval status in your region.