Real‐World Efficacy and Safety of Sintilimab‐Based Regimens against Advanced Esophageal Cancer: A Single‐Center Retrospective Observational Study

Wang, Chenyu; Jin, Linzhi; Cheng, Xinyu; Ren, Runchuan; Zheng, Aijuan; Hao, Anlin; Wang, Nengchao; Zhang, Jinwen; Zhou, Fuyou; Zhang, Yaowen

doi:10.1155/2022/7331687

Cited by 4 publications

(3 citation statements)

References 38 publications

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“…Radiotherapy-ICI combination therapy could increase the OS rates of patients with local recurrence (P = 0.026). Wang et al [21] evaluated 50 advanced esophageal cancer cases treated with sintilimab, of whom 38 had regional lymph node or distant metastasis and 24 received radiotherapy. It have been illustrated that the 1-year OS and PFS rates of the entire group were 67.1% and 49.2% with a median PFS of 11.3 months (95% CI: 5.0-17.6 months).…”

Section: Discussionmentioning

confidence: 99%

Immune checkpoint inhibitors combined with radiotherapy/chemoradiotherapy in treating locally advanced or recurrent/metastatic esophageal squamous cell carcinoma: A real-world study

Zhao

Gao

Wen

et al. 2023

Preprint

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Objective: This study was designed to investigate the prognostic factors for immune checkpoint inhibitors (ICIs) combined utilization with radiotherapy (RT)/chemoradiotherapy (CRT) and to evaluate their toxicity in locally advanced or recurrent/metastatic esophageal squamous cell carcinoma (LA/RM ESCC). Methods: In this study, 198 LA/RM ESCC patients who received ICIs combined with RT/CRT in the Department of Radiotherapy of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS) and progression-free survival (PFS). Subgroup analysis was utilized to explore the prognostic factors, the treatment respond and treatment-related adverse events (trAEs) were analyzed. Results: The median OS and PFS were 30.4 months (95% confidence interval [CI]: 15.1–45.7 months) and 15.3 months (95% CI: 12.8–17.8 months), respectively. The median OS and PFS for patients achieving objective respond (ORR group, including complete response and partial response) were 50.8 months (95% CI: 25.8–75.7 months) and 20.5 months (95% CI: 14.1–27.0), respectively, which were higher than those in non-ORR group (OSnon-ORR:17.5 months, 95% CI: 14.0–21.0; χ2 = 13.881, P < 0.001; PFSnon-ORR: 12.1 months, 95% CI: 10.1–14.1, χ2 = 10.676, P = 0.001). Results from subgroup analysis illustrated combined ICIs with radiotherapy could improve the treatment respond (χ2 = 47.725, P = 0.000). The OS rate (χ2 = 18.836, P < 0.001) and PFS rate (χ2 = 6.881, P = 0.009) were significantly higher in the whole-lesion radiotherapy group than in the partial-lesion radiotherapy group. Multivariate analysis showed that the number of immune cycles, the coverage of radiotherapy target, the modality of ICIs-combination therapy and treatment response were independent prognosis factors for OS (hazard ratio [HR] = 0.512, 2.043, 1.889, and 1.912, respectively; P = 0.001, 0.001, 0.013, and 0.002, respectively). Radiotherapy coverage and treatment response were independent factors for PFS (HR = 1.478 and 1.597, respectively; P = 0.032 and 0.012, respectively). In the entire study population, 83 patients (41.9%) had ≥ grade 2 trAEs. Conclusions: ICIs combined with radiotherapy/chemoradiotherapy are safe and effective in LA/RM ESCC patients. The addition of radiotherapy could improve the treatment respond and whole-lesion radiotherapy improve prognosis compared with partial-lesion radiotherapy group. The number of immunotherapy cycles and treatment response are the main factors affecting prognosis.

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Section: Discussionmentioning

confidence: 99%

Immune checkpoint inhibitors combined with radiotherapy/chemoradiotherapy in treating locally advanced or recurrent/metastatic esophageal squamous cell carcinoma: A real-world study

Zhao

Gao

Wen

et al. 2023

Preprint

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“…Radiotherapy–ICI combination therapy could increase the OS rates of patients with local recurrence ( P = 0.026). Wang et al [ 20 ] evaluated 50 patients with advanced esophageal cancer treated with sintilimab, of whom 38 had esophageal or regional lymph node metastasis and 24 received radiotherapy. The results showed that the 1-year OS and PFS rates of the entire group were 67.1% and 49.2%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Immune checkpoint inhibitors combined with or without radio(chemo)therapy for locally advanced or recurrent/metastatic esophageal squamous cell carcinoma

Zhao,

Gao,

Wen

et al. 2023

Discov Onc

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Objective This study was designed to investigate the efficacy and prognostic factors for immune checkpoint inhibitors (ICIs) combined with or without radio(chemo)therapy and to evaluate their toxicity in patients with locally advanced or recurrent/metastatic esophageal squamous cell carcinoma (LA/RM ESCC). Methods In this study, 198 patients with locally advanced or recurrent/metastatic (LA/RM) ESCC who received ICIs combined with or without radiotherapy/chemotherapy in the Department of Radiotherapy of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS) and progression free survival (PFS). The factors affecting treatment response and the occurrences of treatment-related adverse events (trAEs) were analyzed. Results The median OS and PFS were 30.4 months (95% confidence interval [CI] 15.1–45.7 months) and 15.3 months (95% CI 12.8–17.8 months), respectively. Univariate and multivariate analysis showed that the number of ICI cycles, the intervention of radiotherapy and dysphagia were independent factors affecting OS (Hazard ratio [HR] = 0.39, 2.043 and 0.365, respectively; P = 0.018, 0.001 and 0.032, respectively). The intervention of radiotherapy was an independent factor for PFS (hazard ratio [HR] = 18.149, P = 0.013). The median OS and PFS for patients who had complete response and partial response (Objective response, ORR) were 50.8 months (95% CI 25.8–75.7 months) and 20.5 months (95% CI 14.1–27.0), respectively, which were significantly higher than those in the non-ORR group (OSnon-ORR:17.5 months, 95% CI 14.0–21.0; χ2 = 13.881, P < 0.001; PFSnon-ORR: 12.1 months, 95% CI 10.1–14.1, χ2 = 10.676, P = 0.001). The intervention of radiotherapy could improve treatment response (χ2 = 47.725, P = 0.000). In entire study population, 83 patients (41.9%) had ≥ grade 2 trAEs. Conclusions ICIs combined with radiotherapy/chemotherapy are safe and effective in LA/RM ESCC patients. Intervention of radiotherapy, the number of immunotherapy cycles and occurrence of dysphagia affecting the overall survival of LR/RM ESCC patients. Intervention of radiotherapy was an independent prognosis factor for OS and PFS and associated with better treatment response.

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“…Recent studies have reported controllable and acceptable skin manifestations, such as pruritus, maculopapular eruption, and that vitiligo-like lesions may appear in the follow-up treatment process. [18][19][20] Sintilimab is now widely used for its easy accessibility, high efficacy, and economic advantages in immunotherapy. However, immune-related adverse events caused by Sintilimab are not controllable.…”

Section: How To Define the Symptom Of Swelling Along The Vascular Dir...mentioning

confidence: 99%

A rare presentation of Sintilimab-induced swelling along the vessels: Case report

Liu

Xia

et al. 2023

Medicine

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Rationale: Immune-related adverse events are occasionally reported in Sintilimab treatment. This study reports a forward and reverse swelling case along the vein after infusion of Sintilimab. At present, swelling along the vascular direction during peripheral infusion are limitedly reported at home and abroad, especially when choosing a vein with thick, elastic, and good blood return.Patient concerns: A 56-year-old male who suffered from esophageal cancer and liver cancer and received albumin-bound paclitaxel and nedaplatin chemotherapy in combination with Sintilimab immunotherapy appeared swelling along the vessel after infusion of Sintilimab. The patient was punctured 3 times.Diagnoses: Sintilimab-induced vascular edema may be a side effect resulted from a combination of variables such as relatively poor vascular function of the patient, chemical extravasation, allergic skin reactions, venous valves, vascular intima, and diameter stenosis. Sintilimab rarely causes vascular edema only when drug allergic reaction is the underlying factor. As only a few cases of vascular edema caused by Sintilimab have been reported, causes to such a drug-induced vascular edema remained unclear.Interventions: The swelling was controlled by an intravenous specialist nurse according to delayed extravasation treatment and the doctor anti-allergy treatment, but the uncertainty of repeated puncture and symptom diagnosis caused pain and anxiety to the patient and his family.Outcomes: The symptom of swelling was gradually relieved after the anti-allergic treatment. The patient completed the following drug infusion without discomfort after the third puncture. When the patient was discharged the next day, swelling in his both hands disappeared, and the patient had no anxiety or discomfort.Lessons: The side effects of immunotherapy may accumulate over time. Early identification and appropriate nursing management are the keys to minimizing patients' pain and anxiety. To effectively treat symptoms, nurses could benefit from quickly identifying the source of swelling.

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Real‐World Efficacy and Safety of Sintilimab‐Based Regimens against Advanced Esophageal Cancer: A Single‐Center Retrospective Observational Study

Cited by 4 publications

References 38 publications

Immune checkpoint inhibitors combined with radiotherapy/chemoradiotherapy in treating locally advanced or recurrent/metastatic esophageal squamous cell carcinoma: A real-world study

Immune checkpoint inhibitors combined with radiotherapy/chemoradiotherapy in treating locally advanced or recurrent/metastatic esophageal squamous cell carcinoma: A real-world study

Immune checkpoint inhibitors combined with or without radio(chemo)therapy for locally advanced or recurrent/metastatic esophageal squamous cell carcinoma

A rare presentation of Sintilimab-induced swelling along the vessels: Case report

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