Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2023; 29(41): 5641-5656
Published online Nov 7, 2023. doi: 10.3748/wjg.v29.i41.5641
Long-term efficacy and predictors of pembrolizumab-based regimens in patients with advanced esophageal cancer in the real world
Hong-Chi Wang, Xiang Huang, Jing Chen, Ye Li, Yang Cong, Bao-Lin Qu, Sheng-Qiang Feng, Fang Liu
Hong-Chi Wang, Xiang Huang, Jing Chen, Ye Li, Yang Cong, Bao-Lin Qu, Fang Liu, Department of Radiotherapy, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Sheng-Qiang Feng, Health Service, The Guard Bureau of Joint Staff Department of Chinese PLA, Beijing 100017, China
Author contributions: Liu F, Wang HC, and Huang X were involved in the study conception and design; Wang HC, Huang X, and Feng SQ drafted the article and interpreted the data; Chen J, Li Y, and Cong Y collected and analyzed the data; Qu BL supervised the report.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of the General Hospital of the Chinese People’s Liberation Army, No. S2021-265-01.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Liu, MD, Chief Physician, Department of Radiotherapy, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. liufangfsq@163.com
Received: July 27, 2023
Peer-review started: July 27, 2023
First decision: September 26, 2023
Revised: October 7, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 7, 2023
Processing time: 103 Days and 3.3 Hours
ARTICLE HIGHLIGHTS
Research background

Although pembrolizumab combined with chemotherapy has been proven effective as first-line therapy in patients with advanced esophageal cancer, few trials have assessed the safety and efficacy of this treatment in patients with locally advanced disease.

Research motivation

Progress has been made in the immune checkpoint inhibitors combined with chemotherapy as the first-line treatment of advanced esophageal cancer. The efficacy and safety of pembrolizumab in locally advanced or metastatic esophageal squamous cell carcinoma (ESCC) in the real world were worth studying.

Research objectives

To analyze the long-term outcomes of pembrolizumab in locally advanced or metastatic ESCC in the real world.

Research methods

This was a single-arm, single-center, retrospective clinical study. Patients who were initially diagnosed with locally advanced or metastatic esophageal cancer from October 1, 2019 to October 1, 2021 were included. According to the different clinical stages and treatment modalities, the patients were divided into different subgroups. Long-term survival outcomes were evaluated.

Research results

A total of 55 patients with ESCC were enrolled in this study from October 1, 2019 to October 1, 2021. The median overall survival (OS) in all patients was not reached. The 12-mo OS rate was 78.8% and the 18-mo OS rate was 72.7%. Nine patients died due to tumor progression and 7 patients died due to treatment-related complications.

Research conclusions

Pembrolizumab combined with chemotherapy or radiotherapy resulted in favorable long-term survival in patients with locally advanced or metastatic ESCC, with safe and manageable long-term adverse effects.

Research perspectives

It is necessary to explore the efficacy of pembrolizumab combined with chemotherapy or radiotherapy in patients with locally advanced or metastatic ESCC. Randomized phase III trials should be carried out for further verification of the efficacy.