Abstract
BackgroundCamrelizumab (a PD-1 inhibitor) has been used as a potential therapy in unresectable advanced esophageal squamous cell carcinoma (ESCC) along with adjuvant treatment in locally advanced ESCC, exhibiting an acceptable efficacy and safety profile. This pilot study was designed to further investigate the clinical value and tolerance of neoadjuvant camrelizumab plus chemotherapy in locally advanced ESCC.MethodsA total of 16 patients with locally advanced ESCC were recruited. Patients received 2 cycles of neoadjuvant therapy including 2 doses of camrelizumab concurrent with 2 cycles of paclitaxel plus carboplatin followed by surgery 4 weeks afterward. Then, the treatment response after neoadjuvant therapy, R0 resection rate, tumor regression grade (TRG), and pathological complete remission (pCR) rate were measured. Besides, adverse events were documented. At last, progression-free survival (PFS) and overall survival (OS) were assessed.ResultsGenerally, objective remission rate (ORR) was 81.3% whereas disease control rate (DCR) was 100% after neoadjuvant therapy. Concerning TRG grade, 31.3, 37.5, 18.8, and 12.5% patients reached TRG0, TRG1, TRG2, and TRG3, respectively. Then, pCR rate and R0 resection rate were 31.3 and 93.8%, respectively. Besides, mean PFS and OS were 18.3 months (95%CI: (16.2–20.5) months) and 19.2 months (95%CI: (17.7–20.7) months), respectively, with a 1-year PFS of 83% and OS of 90.9%. Adverse events included white blood cell decrease (37.5%), neutrophil decrease (31.3%), reactive cutaneous capillary endothelial proliferation (37.5%), and nausea or vomiting (25.0%), which were relatively mild and manageable.ConclusionNeoadjuvant camrelizumab plus chemotherapy exhibits good efficacy and acceptable tolerance in patients with locally advanced ESCC.
Highlights
Esophageal squamous cell carcinoma (ESCC), with a proportion of 87% in all esophageal cancer, exhibits a more extensive intratumor heterogeneity and a higher mortality [1,2,3]
Camrelizumab, a domestic product developed in China, is a novel IgG4-kappa anti-Programmed cell death protein 1 (PD-1) inhibitor that has been used for treatment of a variety of malignancies, such as refractory classical Hodgkin’s lymphoma and gastric or gastroesophageal junction adenocarcinoma [15, 16]
A total of 16 patients with locally advanced esophageal squamous cell carcinoma (ESCC) who were recruited between July 1, 2019, and December 31, 2020, and received camrelizumab combined with chemotherapy as neoadjuvant therapy before surgery in our hospital
Summary
Esophageal squamous cell carcinoma (ESCC), with a proportion of 87% in all esophageal cancer, exhibits a more extensive intratumor heterogeneity and a higher mortality [1,2,3]. In locally advanced ESCC, nivolumab and pembrolizumab combination with chemotherapy was recently used for neoadjuvant therapy, which exhibited an acceptable therapeutic response, progression-free survival (PFS), and overall survival (OS) [9]. Camrelizumab (a PD-1 inhibitor) has been used as a potential therapy in unresectable advanced esophageal squamous cell carcinoma (ESCC) along with adjuvant treatment in locally advanced ESCC, exhibiting an acceptable efficacy and safety profile.
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