2069 - Four-year Outcomes of Neoadjuvant Chemoimmunotherapy vs. Chemoradiotherapy in Resectable Esophageal Squamous Cell Carcinoma: A Multicenter Real-World Study
Presenter(s)
X. Zheng1, H. Ge2, S. Yang3, W. Zhang4, H. Wang5, X. Wang6, H. Liu7, and X. M. Wang8; 1Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China, 2Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China, 3Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, Zhengzhou, Henan, China, 4Tianjin Medical University Cancer Institute & Hospital, Tianjin, China, 5Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, 6Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China, 7Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, 8Department of Radiation Oncology, Anyang Tumor Hospital, Anyang, China
Purpose/Objective(s): This multicenter study evaluated survival and pathological outcomes between neoadjuvant chemoimmunotherapy (nCIT) and neoadjuvant chemoradiotherapy (nCRT) for resectable locally advanced esophageal squamous cell carcinoma (LA-ESCC).
Materials/Methods: We reviewed 1,030 LA-ESCC cases received nCIT (n = 528) or nCRT (n = 502) between January 1, 2019 and December 31, 2023. The primary endpoint was overall survival (OS); the secondary endpoints was pathological complete response (pCR). The adjusted baseline characteristics were in propensity score matching (PSM) and inverse probability treatment weighting (IPTW).
Results: After PSM, each group had 419 patients. After a median (IQR) follow-up of 56.7 months (IQR 46.4–72.6), the nCIT group demonstrated 2- and 4-year OS rates of 87.6% and 75.6%, respectively, versus 85.2% and 74.1% for nCRT (HR 1.15, 95% CI 0.90-1.47, P = 0.21). Pathological results showed that nCRT had a higher pCR rate compared to nCIT (39.4% vs 25.1%, P < 0.01).
Conclusion: The study demonstrated no difference in survival of nCIT compared with nCRT in resectable LA-ESCC, even with a very low pCR. These findings should be confirmed by prospective randomized controlled trials.