The Efficacy and Safety of Penpulimab in the Treatment of Metastatic PPGL Patients Who Fail to Other Systemic Treatment

Inclusion Criteria:

• Provide written informed consent.
• Age 18-75 years old
• Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2.
• Patients with histologically or radiologically confirmed MPP and fail to othersystemic therapy.
• Estimated life expectancy longer than 6 months.
• Confirmed non-pregnancy and lactation. During the entire study period and within 6months after the last administration, the subjects and their spouses are willing touse efficient contraceptive measures.
• Laboratory requirements:
• Absolute granulocyte count (AGC) greater than 1.5 x 109/L;
• Platelet count greater than 80 x 109/L;
• Hemoglobin greater than 90g/L;
• Serum bilirubin less than 1.5 x upper limit of normal (ULN); --)Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) lessthan 2.5 x ULN;
• Serum creatinine less than 1.5 x ULN or creatinine clearance (CCr)≥60ml/min;
• Doppler ultrasound assessment: left ventricular ejection fraction (LVEF) ≥ lowerlimit of normal value (50%).

Exclusion Criteria:

• Patients who had been previously treated with anti-PD1, anti-PD-L1, or anti-PD-L2medications were excluded from this trial.
• Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or anyother form of immunosuppressive therapy within 14 days prior to the first dose oftrial treatment.
• Has a known history of active TB (Bacillus Tuberculosis).
• Has a known history of Human Immunodeficiency Virus (HIV).
• Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).
• Has an active infection requiring systemic therapy.
• Didn't meet eligibility for organ function.
• Abnormal coagulation (INR >1.5 or prothrombin time (PT) > ULN 4 seconds or APTT >1.5ULN), bleeding tendency or being treated with thrombolytic or anticoagulant therapy.
• Uncontrolled congestive heart failure .