Neoadjuvant chemotherapy combined with an immune checkpoint inhibitor (ICI) is safe and effective in patients with resectable esophageal cancer, according to research presented at the American Association for Thoracic Surgery (AATS) Annual Meeting.

In this real-world study, patients received 1 of 4 ICIs in combination with chemotherapy prior to surgery. More than 75% of patients were still alive and event-free at 1 year, and the treatment was tolerable, according to researchers.

This study included 177 patients with resectable esophageal cancer. The patients’ mean age at surgery was 62 years, 132 patients were men, and 45 were women.

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Between January 2019 and January 2022, the patients received neoadjuvant pembrolizumab (n=57), tislelizumab (n=47), camrelizumab (n=44), or sintilimab (n=29) combined with chemotherapy.

The median follow-up was 14 months. The pathologic complete response rate was 32.3%, and the R0 resection rate was 99.4%. The 1-year event-free survival rate was 78.3%, and the 1-year overall survival rate was 88.0%. 

The postoperative complication rate was 35.6%. The rate of grade 3 or higher treatment-related adverse events was 18.1%. These events were leukopenia (7.9%), neutropenia (3.4%), thrombocytopenia (3.4%), anemia (2.8%), and hyperglycemia (0.6%).

Based on these results, the researchers concluded that the 4 ICIs, when combined with neoadjuvant chemotherapy, have tolerable toxicity profiles and provide good short-term survival. 


Ke L, Yan X, Ni Y, Zhao J. Real world effectiveness and safety analysis of resectable esophageal cancer following neoadjuvant immunotherapy. AATS 2023. May 6-9, 2023. Abstract PS61.