Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting
BackgroundKEYNOTE-181, ATTRACTION-3, and ESCORT trials have opened the era of programmed death 1 (PD-1) inhibitors in the second-line therapy for esophageal squamous cell carcinoma (ESCC). There is no head-to-head comparison of pembrolizumab vs. nivolumab vs. camrelizumab in the second-line setting...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-09-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.698732/full |
| _version_ | 1818437012637614080 |
|---|---|
| author | Yi-Xin Zhou Ping Chen Yu-Ting Sun Bei Zhang Miao-Zhen Qiu |
| author_facet | Yi-Xin Zhou Ping Chen Yu-Ting Sun Bei Zhang Miao-Zhen Qiu |
| author_sort | Yi-Xin Zhou |
| collection | DOAJ |
| description | BackgroundKEYNOTE-181, ATTRACTION-3, and ESCORT trials have opened the era of programmed death 1 (PD-1) inhibitors in the second-line therapy for esophageal squamous cell carcinoma (ESCC). There is no head-to-head comparison of pembrolizumab vs. nivolumab vs. camrelizumab in the second-line setting for ESCC. We performed an indirect comparison to explore the optimal choice of immune checkpoint inhibitor (ICI) for advanced ESCC.MethodsPatients in ATTRACTION-3 and ESCORT were all squamous carcinoma, while KEYNOTE-181 enrolled both adenocarcinoma and squamous carcinoma patients. We only extract information of patients with squamous carcinoma from KEYNOTE 181 study and all the patients from ATTRACTION-3 and ESCORT. The main clinical outcomes for this study were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs).ResultsIndirect analysis showed similar survival benefit among three PD-1 inhibitors. Nivolumab was comparable with pembrolizumab in most subgroups except that nivolumab was slightly better for patients with performance status (PS) score of 1 [HRnivo/pembro: 0.68 (95% confidence interval (CI): 0.45–1.02], p = 0.07). Compared with nivolumab indirectly, pembrolizumab and camrelizumab had better PFS [HRpembro/nivo: 0.85 (95% CI: 0.63–1.14), p = 0.29; HRcam/nivo: 0.64 (95% CI: 0.47–0.87), p = 0.004] and significantly higher ORR [RRpembro/nivo: 2.51 (95% CI: 1.22–5.15), p = 0.01; RRcam/nivo: 3.52 (95% CI: 1.73–7.18), p = 0.001]. Compared with camrelizumab indirectly, pembrolizumab had slightly worse PFS [HRpembro/cam: 1.33 (95% CI: 0.99–1.79), p = 0.057] and comparable ORR [RRpembro/cam: 0.71 (95% CI: 0.32–1.60; p = 0.41)]. Camrelizumab had a significantly higher rate of all grade TRAEs than both pembrolizumab and nivolumab.ConclusionsCombining the safety and potential survival benefit, we recommend nivolumab for ESCC patients with PS score of 1 and pembrolizumab or camrelizumab for patients with better PS and seeking for higher efficacy or longer PFS. |
| first_indexed | 2024-12-14T17:17:54Z |
| format | Article |
| id | doaj.art-426ff2e6a9bc4be5b04c1f2fd42573f6 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-14T17:17:54Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-426ff2e6a9bc4be5b04c1f2fd42573f62022-12-21T22:53:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-09-011110.3389/fonc.2021.698732698732Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line SettingYi-Xin Zhou0Ping Chen1Yu-Ting Sun2Bei Zhang3Miao-Zhen Qiu4Department of VIP Region, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of VIP Region, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of VIP Region, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaBackgroundKEYNOTE-181, ATTRACTION-3, and ESCORT trials have opened the era of programmed death 1 (PD-1) inhibitors in the second-line therapy for esophageal squamous cell carcinoma (ESCC). There is no head-to-head comparison of pembrolizumab vs. nivolumab vs. camrelizumab in the second-line setting for ESCC. We performed an indirect comparison to explore the optimal choice of immune checkpoint inhibitor (ICI) for advanced ESCC.MethodsPatients in ATTRACTION-3 and ESCORT were all squamous carcinoma, while KEYNOTE-181 enrolled both adenocarcinoma and squamous carcinoma patients. We only extract information of patients with squamous carcinoma from KEYNOTE 181 study and all the patients from ATTRACTION-3 and ESCORT. The main clinical outcomes for this study were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs).ResultsIndirect analysis showed similar survival benefit among three PD-1 inhibitors. Nivolumab was comparable with pembrolizumab in most subgroups except that nivolumab was slightly better for patients with performance status (PS) score of 1 [HRnivo/pembro: 0.68 (95% confidence interval (CI): 0.45–1.02], p = 0.07). Compared with nivolumab indirectly, pembrolizumab and camrelizumab had better PFS [HRpembro/nivo: 0.85 (95% CI: 0.63–1.14), p = 0.29; HRcam/nivo: 0.64 (95% CI: 0.47–0.87), p = 0.004] and significantly higher ORR [RRpembro/nivo: 2.51 (95% CI: 1.22–5.15), p = 0.01; RRcam/nivo: 3.52 (95% CI: 1.73–7.18), p = 0.001]. Compared with camrelizumab indirectly, pembrolizumab had slightly worse PFS [HRpembro/cam: 1.33 (95% CI: 0.99–1.79), p = 0.057] and comparable ORR [RRpembro/cam: 0.71 (95% CI: 0.32–1.60; p = 0.41)]. Camrelizumab had a significantly higher rate of all grade TRAEs than both pembrolizumab and nivolumab.ConclusionsCombining the safety and potential survival benefit, we recommend nivolumab for ESCC patients with PS score of 1 and pembrolizumab or camrelizumab for patients with better PS and seeking for higher efficacy or longer PFS.https://www.frontiersin.org/articles/10.3389/fonc.2021.698732/fullesophageal squamous cell carcinomaPD-1 inhibitorsecond line therapycamrelizumabnivolumabpembrolizumab |
| spellingShingle | Yi-Xin Zhou Ping Chen Yu-Ting Sun Bei Zhang Miao-Zhen Qiu Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting Frontiers in Oncology esophageal squamous cell carcinoma PD-1 inhibitor second line therapy camrelizumab nivolumab pembrolizumab |
| title | Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting |
| title_full | Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting |
| title_fullStr | Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting |
| title_full_unstemmed | Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting |
| title_short | Comparison of PD-1 Inhibitors in Patients With Advanced Esophageal Squamous Cell Carcinoma in the Second-Line Setting |
| title_sort | comparison of pd 1 inhibitors in patients with advanced esophageal squamous cell carcinoma in the second line setting |
| topic | esophageal squamous cell carcinoma PD-1 inhibitor second line therapy camrelizumab nivolumab pembrolizumab |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.698732/full |
| work_keys_str_mv | AT yixinzhou comparisonofpd1inhibitorsinpatientswithadvancedesophagealsquamouscellcarcinomainthesecondlinesetting AT pingchen comparisonofpd1inhibitorsinpatientswithadvancedesophagealsquamouscellcarcinomainthesecondlinesetting AT yutingsun comparisonofpd1inhibitorsinpatientswithadvancedesophagealsquamouscellcarcinomainthesecondlinesetting AT beizhang comparisonofpd1inhibitorsinpatientswithadvancedesophagealsquamouscellcarcinomainthesecondlinesetting AT miaozhenqiu comparisonofpd1inhibitorsinpatientswithadvancedesophagealsquamouscellcarcinomainthesecondlinesetting |