Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma
BackgroundNeoadjuvant chemotherapy (nCT) and chemoradiotherapy (nCRT) are the standard treatments in patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC). Adding PD-1 inhibitor to the chemotherapy has shown significant clinical benefits in first-line treatment of advan...
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| Format: | Article |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.864533/full |
| _version_ | 1818015062551429120 |
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| author | Huilai Lv Yang Tian Jiachen Li Chao Huang Bokang Sun Chunyue Gai Zhenhua Li Ziqiang Tian |
| author_facet | Huilai Lv Yang Tian Jiachen Li Chao Huang Bokang Sun Chunyue Gai Zhenhua Li Ziqiang Tian |
| author_sort | Huilai Lv |
| collection | DOAJ |
| description | BackgroundNeoadjuvant chemotherapy (nCT) and chemoradiotherapy (nCRT) are the standard treatments in patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC). Adding PD-1 inhibitor to the chemotherapy has shown significant clinical benefits in first-line treatment of advanced ESCC. This study evaluated the efficacy and safety of neoadjuvant sintilimab plus chemotherapy in patients with resectable locally advanced ESCC.MethodsThe clinical data of 96 patients with resectable locally advanced ESCC, treated with sintilimab plus chemotherapy followed by esophagectomy, were reviewed. The pathologic complete response (pCR) rate, major pathological response (MPR) rate, R0 resection rate, tumor downstaging, survival, and safety were retrospectively analyzed.ResultsPatients were between the ages of 43 and 78 years (interquartile range [IQR], 60–69 years). Forty (41.7%) were diagnosed with stage II ESCC, 52 (54.2%) with stage III, and 4 (4.2%) with stage IVA. Sixty-seven (69.8%) were male, and 84 (87.5%) patients had an ECOG PS of ≤1. Forty-eight (50.0%) patients received 3–4 cycles of the neoadjuvant treatment. Twenty-nine (30.2%) patients obtained pCR, and MPR was achieved in 60 (62.5%) patients. The R0 resection rate was 99%. Eighty (83.3%) patients achieved clinical downstaging, and 71 (74.0%) achieved pathological downstaging. The median follow-up was 8.9 months, and 1-year DFS rate was 95.2% (95% CI, 88.8%–100%). Grade 3–4 TRAEs occurred in 12 (12.5%) patients, and the incidence of grade 3–4 surgical complications was 2.1%. No deaths were reported.ConclusionThese real-world data revealed that neoadjuvant sintilimab plus chemotherapy could provide encouraging pCR with good tolerability for resectable locally advanced ESCC, and this regimen warrants further exploration in prospective clinical studies. |
| first_indexed | 2024-04-14T06:53:18Z |
| format | Article |
| id | doaj.art-5b45519baf9d4c0d8a6fab839943de6d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-14T06:53:18Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-5b45519baf9d4c0d8a6fab839943de6d2022-12-22T02:06:58ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-04-011210.3389/fonc.2022.864533864533Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell CarcinomaHuilai Lv0Yang Tian1Jiachen Li2Chao Huang3Bokang Sun4Chunyue Gai5Zhenhua Li6Ziqiang Tian7Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Thoracic and Cardiac Surgery, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaBackgroundNeoadjuvant chemotherapy (nCT) and chemoradiotherapy (nCRT) are the standard treatments in patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC). Adding PD-1 inhibitor to the chemotherapy has shown significant clinical benefits in first-line treatment of advanced ESCC. This study evaluated the efficacy and safety of neoadjuvant sintilimab plus chemotherapy in patients with resectable locally advanced ESCC.MethodsThe clinical data of 96 patients with resectable locally advanced ESCC, treated with sintilimab plus chemotherapy followed by esophagectomy, were reviewed. The pathologic complete response (pCR) rate, major pathological response (MPR) rate, R0 resection rate, tumor downstaging, survival, and safety were retrospectively analyzed.ResultsPatients were between the ages of 43 and 78 years (interquartile range [IQR], 60–69 years). Forty (41.7%) were diagnosed with stage II ESCC, 52 (54.2%) with stage III, and 4 (4.2%) with stage IVA. Sixty-seven (69.8%) were male, and 84 (87.5%) patients had an ECOG PS of ≤1. Forty-eight (50.0%) patients received 3–4 cycles of the neoadjuvant treatment. Twenty-nine (30.2%) patients obtained pCR, and MPR was achieved in 60 (62.5%) patients. The R0 resection rate was 99%. Eighty (83.3%) patients achieved clinical downstaging, and 71 (74.0%) achieved pathological downstaging. The median follow-up was 8.9 months, and 1-year DFS rate was 95.2% (95% CI, 88.8%–100%). Grade 3–4 TRAEs occurred in 12 (12.5%) patients, and the incidence of grade 3–4 surgical complications was 2.1%. No deaths were reported.ConclusionThese real-world data revealed that neoadjuvant sintilimab plus chemotherapy could provide encouraging pCR with good tolerability for resectable locally advanced ESCC, and this regimen warrants further exploration in prospective clinical studies.https://www.frontiersin.org/articles/10.3389/fonc.2022.864533/fullesophageal squamous cell carcinomapathologic complete responsecombination therapyimmune checkpoint inhibitorssintilimab |
| spellingShingle | Huilai Lv Yang Tian Jiachen Li Chao Huang Bokang Sun Chunyue Gai Zhenhua Li Ziqiang Tian Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma Frontiers in Oncology esophageal squamous cell carcinoma pathologic complete response combination therapy immune checkpoint inhibitors sintilimab |
| title | Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma |
| title_full | Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma |
| title_fullStr | Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma |
| title_full_unstemmed | Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma |
| title_short | Neoadjuvant Sintilimab Plus Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma |
| title_sort | neoadjuvant sintilimab plus chemotherapy in resectable locally advanced esophageal squamous cell carcinoma |
| topic | esophageal squamous cell carcinoma pathologic complete response combination therapy immune checkpoint inhibitors sintilimab |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.864533/full |
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