The Neoadjuvant Administration of PD-1 Inhibitor plus Concurrent Chemoradiotherapy in Patients with Locally Advanced Esophageal Squamous-Cell Carcinoma

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Journal of Clinical Pharmacy and Therapeutics Pub Date : 2024-04-12 DOI:10.1155/2024/5542947
Yong Chen, Shuangmei Zhu, Xiang Lan, Tianzhen Hu, Lele Ma, Hong Ye, Baoqiang Wang, Xiao He, Hanying Wang
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Abstract

Objective. Programmed cell death-1 (PD-1) inhibitors have shown potency for neoadjuvant therapy in several cancers, while their administration combined with concurrent chemoradiotherapy (CCRT) as a neoadjuvant therapy for locally advanced esophageal squamous-cell carcinoma (ESCC) is seldom reported. The current study aimed to investigate the pathological response, survival, and safety of neoadjuvant PD-1 inhibitor plus CCRT in locally advanced ESCC patients. Methods. Twenty-five locally advanced ESCC patients who underwent PD-1 inhibitor plus CCRT neoadjuvant therapy were retrospectively reviewed. Data regarding radiological response, pathological response, disease-free survival (DFS), overall survival (OS), and adverse events were retrieved. Results. Two (8.0%), 14 (56.0%), 9 (36.0%), and 0 (0.0%) patients had a clinical response of complete response, partial response, stable disease, and progressive disease after neoadjuvant therapy by radiological evaluations, respectively. Notably, 25 (100.0%) patients had successful tumor resections, 24 (96.0%) patients realized R0 resection, and 13 (52.0%) patients achieved pathological complete response (pCR) by pathological evaluations. Regarding survival profiles, the 1-year and 2-year accumulating DFS rates were 90.0% and 74.6%, respectively; then, the 1-year and 2-year accumulating OS rates were 95.5% and 90.4%, respectively. The top prevalent adverse events were fatigue (48.0%), nausea and vomiting (40.0%), leukopenia (36.0%), neutropenia (36.0%), and peripheral neuropathy (36.0%). In addition, grades 3-4 adverse events included peripheral neuropathy (12.0%), nausea and vomiting (4.0%), leukopenia (4.0%), neutropenia (4.0%), anemia (4.0%), and pruritus (4.0%). Conclusion. Neoadjuvant PD-1 inhibitor plus CCRT shows a good efficacy and acceptable tolerance for locally advanced ESCC treatment, but further large-scale study validation is needed.

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局部晚期食管鳞状细胞癌患者新辅助治疗 PD-1 抑制剂和同期化放疗的研究
目的程序性细胞死亡-1(PD-1)抑制剂已在多种癌症的新辅助治疗中显示出疗效,但将其与同期化放疗(CCRT)联合作为局部晚期食管鳞状细胞癌(ESCC)的新辅助治疗却鲜有报道。本研究旨在探讨新辅助 PD-1 抑制剂联合 CCRT 治疗局部晚期 ESCC 患者的病理反应、生存率和安全性。研究方法回顾性研究了25例接受PD-1抑制剂加CCRT新辅助治疗的局部晚期ESCC患者。检索了有关放射学反应、病理学反应、无病生存期(DFS)、总生存期(OS)和不良事件的数据。结果显示通过放射学评估,2 例(8.0%)、14 例(56.0%)、9 例(36.0%)和 0 例(0.0%)患者在新辅助治疗后的临床反应分别为完全反应、部分反应、疾病稳定和疾病进展。值得注意的是,25 例(100.0%)患者成功切除了肿瘤,24 例(96.0%)患者实现了 R0 切除,13 例(52.0%)患者通过病理评估获得了病理完全反应(pCR)。在生存率方面,1年和2年累计DFS率分别为90.0%和74.6%,1年和2年累计OS率分别为95.5%和90.4%。最常见的不良反应是疲劳(48.0%)、恶心和呕吐(40.0%)、白细胞减少(36.0%)、中性粒细胞减少(36.0%)和周围神经病变(36.0%)。此外,3-4 级不良事件包括周围神经病变(12.0%)、恶心呕吐(4.0%)、白细胞减少(4.0%)、中性粒细胞减少(4.0%)、贫血(4.0%)和瘙痒(4.0%)。结论新辅助PD-1抑制剂联合CCRT治疗局部晚期ESCC显示出良好的疗效和可接受的耐受性,但还需要进一步的大规模研究验证。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
226
审稿时长
6 months
期刊介绍: The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.
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