Changing landscape of advanced esophageal squamous cell carcinoma: Breakthroughs in systemic therapies (Review)

Rákkutatás · Esophageal cancer

Immunotherapy significantly improves outcomes in advanced esophageal cancer.

Currently, immune checkpoint inhibitors (ICIs) have become a mainstay in treating advanced esophageal cancer (EC), yet the predictive significance of routinely collected clinicopathological characteristics for overall survival (OS) remains uncertain. A meta‑analysis of 13 phase III randomized controlled trials involving 7,696 patients showed that immunotherapy was associated with favorable overall survival (HR = 0.73; 95% CI = 0.69–0.77; P < 0.001). Both PD‑L1–positive and PD‑L1–negative patients can benefit from ICIs, but a robust PD‑L1 expression–treatment interaction was observed (P_interaction = 0.004). Esophageal squamous cell carcinoma (ESCC) patients (HR = 0.73; 95% CI = 0.64–0.84) experienced survival benefits, whereas esophageal adenocarcinoma (EAC) patients (HR = 0.92; 95% CI = 0.76–1.13) did not. Asian patients derived greater benefits (HR = 0.68; 95% CI = 0.62–0.75) than non‑Asian patients (HR = 0.81; 95% CI = 0.77–0.91; P_interaction = 0.03). ICIs conferred consistent OS benefits across most clinicopathological subgroups.”,

Identifying clinicopathological factors that predict benefit from ICIs can guide personalized treatment decisions and optimize patient outcomes.

Bizonyítékszint: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.

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