PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level
Abstract Background Immunochemotherapy has become a new treatment for advanced esophageal squamous cell carcinoma (ESCC). Aims We aimed to study the clinical efficacy and toxicity of immunochemotherapy based on PD‐1/PD‐L1 compared with chemotherapy alone in the treatment of advanced ESCC, focusing o...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Cancer Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cnr2.1794 |
| _version_ | 1797773558373416960 |
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| author | Zixian Jin Jiping Wang Jiajing Sun Chengchu Zhu Jian Zhang Bo Zhang |
| author_facet | Zixian Jin Jiping Wang Jiajing Sun Chengchu Zhu Jian Zhang Bo Zhang |
| author_sort | Zixian Jin |
| collection | DOAJ |
| description | Abstract Background Immunochemotherapy has become a new treatment for advanced esophageal squamous cell carcinoma (ESCC). Aims We aimed to study the clinical efficacy and toxicity of immunochemotherapy based on PD‐1/PD‐L1 compared with chemotherapy alone in the treatment of advanced ESCC, focusing on analyzing the influence of PD‐L1 expression level. Methods and Results Five randomized controlled trials comparing PD‐1/PD‐L1 based immunochemotherapy with chemotherapy alone for advanced ESCC were included. We extracted efficacy data (objective response rate [ORR], disease control rate [DCR], overall survival [OS] rate, progression‐free survival [PFS] rate) and safety data (treatment‐related adverse events, treatment‐related mortality) and performed meta‐analyses. Compared with chemotherapy alone, the ORR and DCR of immunochemotherapy increased by 2.05 times and 1.54 times, respectively. Overall, patients receiving immunochemotherapy had a significant long‐term survival advantage (OS: hazard ratio [HR] = 0.68, 95% confidence intervals [CI] 0.61–0.75; PFS: HR = 0.62, 95% CI 0.55, 0.70, respectively). Even with PD‐L1 tumor proportion score <1%, immunochemotherapy also showed a significant survival advantage (OS: HR = 0.65, 95% CI 0.46–0.93; PFS: HR = 0.56, 95% CI 0.46–0.69, respectively). However, for PD‐L1 combined positive score (CPS) < 1, the survival advantage of immunochemotherapy was not significant (OS: HR = 0.89, 95% CI 0.42–1.90; PFS: HR = 0.71, 95% CI 0.47–1.08, respectively). The toxicity of immunochemotherapy was higher than that of chemotherapy alone, but there was no statistical difference in treatment‐related mortality (odds ratio = 1.11, 95% CI 0.67–1.83). Conclusion In this study, treatment‐related mortality was similar between immunochemotherapy and chemotherapy. PD‐1/PD‐L1 based immunochemotherapy significantly could improve survival outcomes in patients with advanced ESCC. For patients with CPS <1, the survival advantage of immunochemotherapy was not significant compared with chemotherapy. |
| first_indexed | 2024-03-12T22:08:13Z |
| format | Article |
| id | doaj.art-980a738c37744366919b6aae08b3b0b3 |
| institution | Directory Open Access Journal |
| issn | 2573-8348 |
| language | English |
| last_indexed | 2024-03-12T22:08:13Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Reports |
| spelling | doaj.art-980a738c37744366919b6aae08b3b0b32023-07-24T07:58:57ZengWileyCancer Reports2573-83482023-07-0167n/an/a10.1002/cnr2.1794PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression levelZixian Jin0Jiping Wang1Jiajing Sun2Chengchu Zhu3Jian Zhang4Bo Zhang5Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Linhai ChinaKey Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Linhai ChinaDepartment of Cardiothoracic Surgery Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Linhai ChinaKey Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Linhai ChinaKey Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Linhai ChinaKey Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University Linhai ChinaAbstract Background Immunochemotherapy has become a new treatment for advanced esophageal squamous cell carcinoma (ESCC). Aims We aimed to study the clinical efficacy and toxicity of immunochemotherapy based on PD‐1/PD‐L1 compared with chemotherapy alone in the treatment of advanced ESCC, focusing on analyzing the influence of PD‐L1 expression level. Methods and Results Five randomized controlled trials comparing PD‐1/PD‐L1 based immunochemotherapy with chemotherapy alone for advanced ESCC were included. We extracted efficacy data (objective response rate [ORR], disease control rate [DCR], overall survival [OS] rate, progression‐free survival [PFS] rate) and safety data (treatment‐related adverse events, treatment‐related mortality) and performed meta‐analyses. Compared with chemotherapy alone, the ORR and DCR of immunochemotherapy increased by 2.05 times and 1.54 times, respectively. Overall, patients receiving immunochemotherapy had a significant long‐term survival advantage (OS: hazard ratio [HR] = 0.68, 95% confidence intervals [CI] 0.61–0.75; PFS: HR = 0.62, 95% CI 0.55, 0.70, respectively). Even with PD‐L1 tumor proportion score <1%, immunochemotherapy also showed a significant survival advantage (OS: HR = 0.65, 95% CI 0.46–0.93; PFS: HR = 0.56, 95% CI 0.46–0.69, respectively). However, for PD‐L1 combined positive score (CPS) < 1, the survival advantage of immunochemotherapy was not significant (OS: HR = 0.89, 95% CI 0.42–1.90; PFS: HR = 0.71, 95% CI 0.47–1.08, respectively). The toxicity of immunochemotherapy was higher than that of chemotherapy alone, but there was no statistical difference in treatment‐related mortality (odds ratio = 1.11, 95% CI 0.67–1.83). Conclusion In this study, treatment‐related mortality was similar between immunochemotherapy and chemotherapy. PD‐1/PD‐L1 based immunochemotherapy significantly could improve survival outcomes in patients with advanced ESCC. For patients with CPS <1, the survival advantage of immunochemotherapy was not significant compared with chemotherapy.https://doi.org/10.1002/cnr2.1794PD‐1PD‐L1immunochemotherapysurvivalESCC |
| spellingShingle | Zixian Jin Jiping Wang Jiajing Sun Chengchu Zhu Jian Zhang Bo Zhang PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level Cancer Reports PD‐1 PD‐L1 immunochemotherapy survival ESCC |
| title | PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level |
| title_full | PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level |
| title_fullStr | PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level |
| title_full_unstemmed | PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level |
| title_short | PD‐1/PD‐L1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma: A meta‐analysis focus on PD‐L1 expression level |
| title_sort | pd 1 pd l1 based immunochemotherapy versus chemotherapy alone for advanced esophageal squamous cell carcinoma a meta analysis focus on pd l1 expression level |
| topic | PD‐1 PD‐L1 immunochemotherapy survival ESCC |
| url | https://doi.org/10.1002/cnr2.1794 |
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