The safety and efficacy of neoadjuvant PD-1 inhibitor with chemotherapy for locally advanced esophageal squamous cell carcinoma

doi:10.21037/jgo-20-599

	The safety and efficacy of neoadjuvant PD-1 inhibitor with chemotherapy for locally advanced esophageal squamous cell carcinoma
	Shen, Dijian 1,2; Chen, Qixun 1,2; Wu, Jie 1,2; Li, Jianqiang 1,2; Tao, Kaiyi 1,2; Jiang, Youhua 1,2
刊名	JOURNAL OF GASTROINTESTINAL ONCOLOGY
	2021-02-01
卷号	12
关键词	Neoadjuvant immunotherapy esophageal squamous cell carcinoma (ESCC) thoracic surgery programmed death 1 (PD-1)
ISSN号	2078-6891
DOI	10.21037/jgo-20-599
通讯作者	Jiang, Youhua(jiangyh@zjcc.org.cn)
英文摘要	Background: Neoadjuvant therapy followed by esophagectomy has been recognized as an effective treatment for locally advanced esophageal cancer, though still has a dismal prognosis. Antibodies against programmed death 1 (PD-1) protein improve survival in patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC) compared with chemotherapy in second-line therapy. However, neoadjuvant PD-1 inhibitor combined with chemotherapy has not been tested in locally advanced ESCC. We conducted this study to evaluate the efficacy and safety of pd-1 inhibitor in neoadjuvant chemotherapy. Methods: In this study, we administered 28 adults with untreated, surgically resectable locally advanced ESCC. PD-1 inhibitor with chemotherapy [albumin paclitaxel 100 mg/m(2) on days 1 and 8 + carboplatin with an area under the curve (AUC) of 5 on day 1] were administered every 3 weeks intravenously, and surgery was performed approximately 3-5 weeks after the second dose. The primary purpose of the study was to evaluate the feasibility and safety of this regimen. Results: In all, 28 locally advanced ESCC patients were enrolled, 27 patients received surgery, 9 (33.3%) patients' postoperative pathological specimens suggested pCR, and 11 (40.7%) patients' primary tumor suggested complete response. Neoadjuvant PD-1 inhibitor with chemotherapy had an acceptable side-effect profile, 26 patients' tumors were completely resected (96.3% were R0). According to the RESIST v.1.1, the response in all 27 patients was evaluated by a computed tomography (CT) scan before surgery, showing 12 patients with complete response (CR), 12 with partial response (PR), and 3 with stable disease (SD). For surgical procedures, 15 (55.6%) patients underwent minimal invasive surgery, 4 (14.8%) underwent right transthoracic open esophagectomy, and 8 (29.6%) underwent hybrid approaches. Conclusions: The novel treatment of PD-1 inhibitor with chemotherapy in the neoadjuvant setting for locally advanced ESCC produced satisfactory outcomes: an unprecedentedly high pCR rate for neoadjuvant chemotherapy, a high R0 resection rate, and a low-toxicity profile were achieved. The long-term efficiency of this novel treatment and the validity of the present findings should be confirmed with longer follow-up and prospective comparative trials.
资助项目	Medical Health Science and Technology Project of Zhejiang Provincial Health Commission[2020366703]
WOS关键词	PREOPERATIVE CHEMORADIOTHERAPY ; OPEN-LABEL ; IMMUNE ; PEMBROLIZUMAB ; MULTICENTER ; ANTI-PD-1 ; BLOCKADE ; CRITERIA ; THERAPY
WOS研究方向	Oncology ; Gastroenterology & Hepatology
语种	英语
出版者	AME PUBL CO
WOS记录号	WOS:000623537200001
资助机构	Medical Health Science and Technology Project of Zhejiang Provincial Health Commission
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/120847]
专题	中国科学院合肥物质科学研究院
通讯作者	Jiang, Youhua
作者单位	1.Univ Chinese Acad Sci, Canc Hosp, Dept Thorac Surg, Zhejiang Canc Hosp, 1 Banshan East Rd, Hangzhou 310022, Zhejiang, Peoples R China 2.Chinese Acad Sci, Inst Canc & Basic Med IBMC, Hangzhou, Peoples R China
推荐引用方式 GB/T 7714	Shen, Dijian,Chen, Qixun,Wu, Jie,et al. The safety and efficacy of neoadjuvant PD-1 inhibitor with chemotherapy for locally advanced esophageal squamous cell carcinoma[J]. JOURNAL OF GASTROINTESTINAL ONCOLOGY,2021,12.
APA	Shen, Dijian,Chen, Qixun,Wu, Jie,Li, Jianqiang,Tao, Kaiyi,&Jiang, Youhua.(2021).The safety and efficacy of neoadjuvant PD-1 inhibitor with chemotherapy for locally advanced esophageal squamous cell carcinoma.JOURNAL OF GASTROINTESTINAL ONCOLOGY,12.
MLA	Shen, Dijian,et al."The safety and efficacy of neoadjuvant PD-1 inhibitor with chemotherapy for locally advanced esophageal squamous cell carcinoma".JOURNAL OF GASTROINTESTINAL ONCOLOGY 12(2021).