Neoadjuvant immunotherapy plus chemotherapy produces “promising” results in patients with resectable esophageal cancer, according to researchers.
The researchers conducted a meta-analysis and found that about 30% of patients achieved a pathologic complete response (pCR) with neoadjuvant immunotherapy plus chemotherapy.
In addition, nearly all patients achieved R0 resection. These findings were published in JAMA Network Open.
This meta-analysis included data from 27 open-label, phase 2 randomized clinical trials encompassing a total of 815 patients with resectable stage I-IV esophageal cancer.
All patients received neoadjuvant immunotherapy plus chemotherapy. The primary outcome measures were pCR and major pathologic response (MPR).
The pooled pCR rate was 31.4% overall, 32.4% for patients with esophageal squamous cell carcinoma, and 25.2% for those with esophageal adenocarcinoma.
The MPR rate was 48.9% overall, 49.4% for patients with squamous cell carcinoma, and 42.9% for those with adenocarcinoma.
R0 resection was achieved by 98.6% of patients overall, 98.0% of patients with squamous cell carcinoma, and 100% of those with adenocarcinoma.
The overall rate of treatment-related serious adverse events was 26.9%.
“This study found that neoadjuvant immunotherapy with chemotherapy had promising clinical and safety outcomes for patients with resectable esophageal cancer,” the researchers concluded. They added that randomized clinical trials with longer-term follow-up are warranted.
Ge F, Huo Z, Cai X, et al. Evaluation of clinical and safety outcomes of neoadjuvant immunotherapy combined with chemotherapy for patients with resectable esophageal cancer: A systematic review and meta-analysis. JAMA Netw Open. Published online November 2, 2022. doi:10.1001/jamanetworkopen.2022.39778