The survival outcomes of neoadjuvant sintilimab combined with chemotherapy in patients with locally advanced esophageal squamous cell carcinoma

Abstract

BackgroundNeoadjuvant programmed death receptor-1 (PD-1) inhibitor combined with chemotherapy has been reported to improve the pathological response of locally advanced esophageal squamous cell carcinoma (ESCC), but the systematic report on survival follow-up is quite few. This study we will report the survival follow-up outcomes after a median follow-up of 21.1 months.MethodsThis was a real-world retrospective study. Locally advanced ESCC patients treated with neoadjuvant sintilimab combined with albumin-bound paclitaxel and nedaplatin followed by surgery and completed at least 1-year follow-up were reviewed. The primary outcome was disease-free survival (DFS) at 24 months. The secondary outcome was overall survival (OS) at 24 months.ResultsNinety eligible patients were included in the analysis between July 2019 and October 2021. The median number of neoadjuvant cycles was 3 (range 2-4). All patients achieved R0 resection. With a median follow-up of 21.1 months (range 14.0-39.0), the median DFS and median OS had not reached, 2-year DFS rate was 78.3% (95%CI 68.8%-89.1%) and 2-years OS rate was 88.0% (95%CI 80.6%-96.0%). Postoperative pathological stage, pCR, MPR, tumor down-staging were significantly correlated with favorable survival outcome. Univariable and multivariable Cox regression analysis identified cycle number of neoadjuvant treatment as independent predictor of DFS.ConclusionOur results preliminarily show a survival benefit of neoadjuvant sintilimab combined with chemotherapy in locally advanced ESCC.

Study on the efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy regimen for III–IVA esophageal squamous cell carcinoma post-surgery

“…Zhang [23], Lv [24], Duan [25], and others have investigated the survival benefit of sintilimab in neoadjuvant chemoimmunotherapy for EC, where relatively high pCR rates and safety profiles were reported, but further study is still needed. The current study included 34 patients who met the criteria for post-neoadjuvant surgery, while It is deduced that neoadjuvant immunotherapy in combination with chemotherapy did not lead to increased risks associated with surgery and postoperative complications, which may provide a theoretical basis for the safety of neoadjuvant chemotherapy in combination with immunotherapy.…”

The efficacy and safety of sintilimab combined with chemotherapy as the first-line treatment for metastatic esophageal squamous cell carcinoma

“…Accumulating evidence has shown that the combination of Nab-PTX and PD-1 inhibitor in ESCC exerts an obvious synergistic effect with lower toxicity. [ 18 , 19 ] However, the underlying mechanism remains unknown, possibly because Nab-PTX can improve the efficacy of PD-1 inhibitors by regulating various immune functions. [ 20 , 21 ] More recently, it was found that the synergistic mechanism may lie in depleting the Treg ratio to activate an immune response.…”

Survival outcomes of neoadjuvant immunochemotherapy versus chemotherapy for locally advanced esophageal squamous cell carcinoma

“…Several studies have demonstrated that NICT produced a higher pathological complete response (pCR) rate ranging from 21.7% to 50% with manageable toxicity profile (Zhang et al 2021 ; Yang et al 2022 ; Liu et al 2022a , b . Lv et al 2022 , 2023 ; Yan et al 2022 ; Liu et al 2022a , b ; Zhang et al 2022b ; Chen et al 2023b ; Zhang et al 2023a , b ; Yang et al 2023 ; Yin et al 2022 ; Wang et al 2023 ; Shen et al 2021 ). However, few studies have compared the efficacy and safety of NICT and NCT alone, especially survival outcomes.…”