Comparison of neoadjuvant immunotherapy plus chemotherapy versus chemotherapy alone for patients with locally advanced esophageal squamous cell carcinoma: A propensity score matching.
Comparison of neoadjuvant immunotherapy plus chemotherapy versus chemotherapy alone for patients with locally advanced esophageal squamous cell carcinoma: A propensity score matching.
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DOI：
10.3389/fimmu.2022.970534
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
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免疫检查点抑制剂（ICIs）联合新辅助化疗（nCT）治疗可切除食管鳞状细胞癌（ESCC）的临床研究已开展。到目前为止，很少有研究比较 nCT 加 ICI 和单独 nCT 的生存结果。本研究旨在比较新辅助 ICI 联合 nCT 与 nCT 随后食管切除术治疗可切除局部晚期 ESCC 患者的疗效和安全性。对2013年3月至2021年4月接受nCT或nCT联合ICIs后行食管切除术的ESCC患者进行回顾性分析。进行 1:1 倾向评分匹配 (PSM)，卡尺为 0.01，以平衡潜在偏差。总共选择了47对接受nCT和nCT联合ICIs的ESCC患者进行最终分析。 nCT+ICIs组的肿瘤消退等级（TRG）0级和病理完全缓解（pCR）率显着高于nCT组（分别为21.7% vs. 4.5%，P=0.016；和17.0% vs. 2.1%，P=0.035）。 nCT+ICIs组神经侵犯率为4.3%，显着低于nCT组的23.4%（P=0.007）。 nCT+ICIs组的不良事件发生率与nCT组相似，且两组均未出现5级毒性。两组1年、2年无病生存率（DFS）分别为95.7%、80.7%和76.1%、63.8%（P分别为0.001、0.046）。 nCT+ICIs 组的 1 年 OS 有所改善，接近统计学差异（95.7% vs. 84.8%，P=0.074）。 nCT+ICIs组局部复发率为6.4%，显着低于nCT组的21.3%（P=0.036），而远处转移差异无统计学意义。与单纯nCT相比，新辅助免疫治疗联合nCT治疗局部进展期食管鳞癌患者在病理缓解方面具有优势，可提高DFS，具有良好的安全性和可行性，但长期生存仍需进一步验证。
Clinical studies on immune checkpoint inhibitors (ICIs) combined with neoadjuvant chemotherapy (nCT) have been carried out for the resectable esophageal squamous cell carcinoma (ESCC). So far, few studies have compared the survival outcomes of nCT plus ICIs and nCT alone. This study aimed to compare the efficacy and safety of neoadjuvant ICIs combined with nCT versus nCT followed by esophagectomy for patients with resectable locally advanced ESCC. A retrospective analysis of ESCC patients underwent nCT or nCT combined with ICIs followed by esophagectomy (from March 2013 to April 2021) was performed. A 1:1 propensity score matching (PSM) with a caliper 0.01 was conducted to balance potential bias. A total of 47 comparable pairs of ESCC patients receiving nCT and nCT combined with ICIs were selected for the final analysis. The tumor regression grade (TRG) 0 and pathologic complete response (pCR) rates in the nCT+ICIs group were significantly higher than those of the nCT group (21.7% vs. 4.5%, P=0.016; and 17.0% vs. 2.1%, P=0.035, respectively). The rate of nerve invasion was 4.3% in the nCT+ICIs group, significantly lower than 23.4% of the nCT group (P=0.007). The incidences of adverse events in the nCT+ICIs group were similar compared with the nCT group and there was no grade 5 toxicity in either group. The 1-, 2-year disease-free survival rates (DFS) were 95.7%, 80.7% and 76.1%, 63.8% in the two groups (P=0.001, and P=0.046, respectively). The 1-year OS was improved in the nCT+ICIs group, which was close to a statistical difference (95.7% vs. 84.8%, P=0.074). Local recurrence rate in the nCT+ICIs group was 6.4%, significantly lower than 21.3% of the nCT group (P=0.036), while there was no significant difference in the distant metastasis. Compared with nCT alone, neoadjuvant immunotherapy plus nCT for patients with locally advanced ESCC has an advantage in pathological response, and could improve DFS with a good safety and feasibility, while long term survival validation is still needed further.
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影响因子：
2.1
作者：
Huang, Bingjiang;Shi, Haiyan;Li, Xiaojian
通讯作者：
Li, Xiaojian
影响因子：
2.5
作者：
Wu Z;Zheng Q;Chen H;Xiang J;Hu H;Li H;Pan Y;Peng Y;Yao X;Liu P;Sun Y;Li B;Zhang Y
通讯作者：
Zhang Y
影响因子：
64.8
作者：
Lu Z;Zou J;Li S;Topper MJ;Tao Y;Zhang H;Jiao X;Xie W;Kong X;Vaz M;Li H;Cai Y;Xia L;Huang P;Rodgers K;Lee B;Riemer JB;Day CP;Yen RC;Cui Y;Wang Y;Wang Y;Zhang W;Easwaran H;Hulbert A;Kim K;Juergens RA;Yang SC;Battafarano RJ;Bush EL;Broderick SR;Cattaneo SM;Brahmer JR;Rudin CM;Wrangle J;Mei Y;Kim YJ;Zhang B;Wang KK;Forde PM;Margolick JB;Nelkin BD;Zahnow CA;Pardoll DM;Housseau F;Baylin SB;Shen L;Brock MV
通讯作者：
Brock MV
影响因子：
3.7
作者：
Ando, Nobutoshi;Kato, Hoichi;Fukuda, Haruhiko
通讯作者：
Fukuda, Haruhiko
影响因子：
6.4
作者：
Ryan, R;Gibbons, D;Sheahan, K
通讯作者：
Sheahan, K