Literature DB >> 36267734

Evaluation of the safety and effectiveness of neoadjuvant combined chemoimmunotherapy in the treatment of locally advanced esophageal squamous cell carcinoma: a retrospective single-arm cohort study.

Pinghui Xia1, Pan Li2, Simeng Wu3, Yiqing Wang1, Peng Ye1, Chong Zhang1, Jian Hu1, Biniam Kidane4, Savvas Lampridis5, Jeffrey B Velotta6, Connor J Wakefield7, Linhai Zhu1, Luming Wang1.   

Abstract

Background: Transforming potentially resectable advanced esophageal squamous cell carcinoma (ESCC) into resectable ESCC through preoperative induction therapy is an important component of ESCC comprehensive treatment. Immune checkpoint inhibitor (ICI) therapy has been shown to have significant effects in the treatment of advanced ESCC, but its role in the neoadjuvant treatment of potentially resectable ESCC is unclear. This study aims to investigate the safety and effectiveness of camrelizumab combined with chemotherapy in the neoadjuvant treatment of ESCC.
Methods: We recruited consecutive patients with potentially resectable ESCC who received preoperative camrelizumab in combination with chemotherapy. Data including demographic data, clinicopathological characteristics, neoadjuvant treatment regimens, lesion changes observed by imaging, and surgical details were retrospectively collected through specially designed forms. Toxic effects of neoadjuvant therapy on hematology, gastrointestinal tract, liver, kidney, skin, and thyroid were also collected. Imaging assessments were performed every 1-2 treatment cycles. Follow-up is based on the patient's regular admission to the hospital for examination and treatment, at least 3 months after surgery.
Results: A total of 66 patients with locally advanced ESCC were included in this study, including 8 patients with stage II, 29 patients with stage III, and 29 patients with stage IVA. The objective response rate (ORR) of the neoadjuvant immunotherapy combined with chemotherapy was 75.76% (50/66), and no one developed disease progression. A total of 60 patients underwent surgery, and the R0 resection rate was 98.3% (59/60). The pathological complete remission (pCR) rate and the major pathological response (MPR) rate was 6.7% (4/60) and 20% (12/60), respectively. There were 14 cases of treatment-related adverse reactions >3, but no perioperative deaths occurred. Conclusions: Neoadjuvant immunotherapy combined with chemotherapy followed by surgical resection may be an available treatment for patients with locally advanced ESCC. 2022 Annals of Translational Medicine. All rights reserved.

Entities:  

Keywords:  Esophageal squamous cell carcinoma (ESCC); camrelizumab; immunotherapy; locally advanced; neoadjuvant therapy

Year:  2022        PMID: 36267734      PMCID: PMC9577786          DOI: 10.21037/atm-22-4268

Source DB:  PubMed          Journal:  Ann Transl Med        ISSN: 2305-5839


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9.  World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

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Journal:  JAMA       Date:  2013-11-27       Impact factor: 56.272

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