Apatinib Combined With Camrelizumab in Treating Participants With Advanced Chordoma

Inclusion Criteria:

1. Age ≥ 16 years old, male or female; 2. The physical status score of the Eastern CancerCollaboration Group (ECOG) was 0-1; 3. Expected survival ≥3 months; 4. Patients withadvanced chordoma confirmed by histopathology; 5. Imaging was available to evaluate thelesions. According to the evaluation criteria for solid tumor efficacy (RECIST 1.1, seeAnnex 2), there was at least one single-diameter measurable lesion, whose longest diameterwas measured by spiral CT ≥ 10 mm; 6. All acute toxicities resulting from prior antitumortherapy were resolved to grade 0-1 (according to NCI CTCAE version 5.03) or to the levelspecified in the enrollment/exclusion criteria prior to enrollment (except for toxicitiessuch as alopecia that the investigator determined did not pose a safety risk to thesubject); If subjects undergo major surgery, they must have fully recovered fromcomplications before starting treatment; 7. If the major organs function normally, thefollowing criteria are met:
2. The standard of blood routine examination should be met (no blood transfusion andblood products within 14 days, no G-CSF and other hematopoietic stimulating factorsare used to correct) :
3. Hemoglobin (Hb) ≥ 80 g/L;
4. Neutrophil count (ANC) ≥ 1.5×109/L;
5. Platelet count (PLT) ≥ 80×109/L;
6. Biochemical examination shall meet the following standards:
7. Total bilirubin (TBIL) < 1.5 ULN;
8. ALT and AST < 2.5ULN, and < 5ULN in patients with liver metastasis; Alkalinephosphatase < 5ULN;
9. Serum Cr ≤ ULN or endogenous creatinine clearance > 45 ml/min. 8. Women ofchildbearing age must have used reliable contraception or had a pregnancy test (serum or urine) within 7 days prior to enrol, with a negative result, and bewilling to use an appropriate method of contraception during the trial period and 60 days after the last dose of the test drug. For men, consent to use appropriatemethods of contraception or surgical sterilization during the trial period andfor 120 days after the last dose of the trial drug; 9. The subjects voluntarilyjoined the study and signed the informed consent, with good compliance andfollow-up.

Exclusion Criteria:

1. Except for those subjects whose toxicity had not recovered from previous antitumortherapy (concurrent chemoradiotherapy, surgical treatment) (alopecia, alkalinephosphatase, glutamine detranspeptase (GGT)) or who could be enrolled after discussionwith the investigator and sponsor
2. Use of immunosuppressive drugs within 14 days prior to first use of carrilizumab,excluding nasal and inhaled corticosteroids or systemic steroid hormones atphysiological doses (i.e., no more than 10 mg/ day of prednisolone or othercorticosteroids at pharmacologically equivalent doses);
3. Previous treatment with anti-PD-1, anti-PD-L1, anti-VEGFR antibodies or anti-PD-L2drugs or drugs that target another stimulus or synergistically inhibit T cellreceptors (e.g., CTLA-4, OX-40, CD137);
4. Uncontrolled hypertension (systolic blood pressure ≥ 150 mmHg or diastolic bloodpressure ≥ 90 mmHg, despite systematic medication);
5. Severe cardiovascular disease: Grade II or above myocardial ischemia or myocardialinfarction, poorly controlled arrhythmias (including QTc interval ≥450 ms for men and ≥470 ms for women); Grade Ⅲ to Ⅳ cardiac insufficiency (according to the New YorkHeart Society NYHA classification, see Annex 3), or left ventricular ejection fraction (LVEF) < 50% indicated by cardiac color ultrasound;
6. Patients with any active autoimmune disease or history of autoimmune disease (including but not limited to: autoimmune hepatitis, interstitial pneumonia, uveitis,enteritis, hypophysitis, vasculitis, nephritis, hyperthyroidism, hypothyroidism) arenot included;
7. The subjects were treated with bronchodilators and other systemic treatments, buttheir asthma control was unsatisfactory and they could not be included (those whoseasthma had been completely relieved in childhood could be included without anyintervention after adulthood).
8. Urine routine suggests urinary protein ≥ ++, or confirms 24-hour urinary proteinvolume ≥1.0g;
9. Abnormal coagulation function (INR >1.5 ULN or prothrombin time (PT) > ULN+4 secondsor APTT >1.5 ULN), have a tendency to bleed or are receiving thrombolytic oranticoagulant therapy; Note: Under the premise of INR ≤ 1.5, the use of low doseheparin (adult daily dose of 0.6 thousand to 12 thousand U) or low dose aspirin (dailydose of 100 mg or less) is permitted for preventive purposes;
10. A severe infection occurring within 4 weeks prior to the first dose (e.g., requiringintravenous antibiotic, antifungal, or antiviral medication), or an unexplained fever >38.5°C during the screening period/prior to the first dose;
11. Severe arteriovenous thrombosis events, such as cerebrovascular accidents (includingtemporary ischemic attack, cerebral hemorrhage, cerebral infarction), deep veinthrombosis and pulmonary embolism, occurred within 12 months before enrollment;
12. Had undergone major surgery or severe traumatic injury, fracture or ulcer within 4weeks prior to enrollment;
13. Human immunodeficiency virus (HIV) infection or known acquired immunodeficiencysyndrome (AIDS), active tuberculosis, active hepatitis B (HBV DNA ≥ 500 IU/ml),hepatitis C (hepatitis C antibody positive, And HCV-RNA is higher than the lower limitof detection method) or co-infected with hepatitis B and hepatitis C;
14. Patients with a clear history of allergy may have an underlying allergy or intoleranceto the biologics of Apatinib and carrilizumab;
15. There are significant factors affecting the absorption of oral drugs, such asinability to swallow, chronic diarrhoea and intestinal obstruction. Or have cavity orperforation of viscera or sinus within 6 months;
16. Those who have a history of psychotropic drug abuse and cannot quit or have mentaldisorders;
17. Increases the risks associated with study participation or study drugs and, in theinvestigator's judgment, may result in other conditions for which the patient is noteligible for study enrollment.