2252 - Nimotuzumab Combined with Chemoradiotherapy vs. Chemoradiotherapy Alone in Advanced Esophageal Cancer: A Systematic Review and Meta-Analysis of Survival and Safety Outcomes

03:00pm - 04:00pm ET

Poster Hall - Exhibit Hall A

Screen: 25

POSTER

Presenter(s)

Lan Wang, MD, PhD - The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei

X. Chen¹, Y. Zhao², X. Ren¹, L. Liu¹, C. Han¹, and L. Wang¹; ¹Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China, ²The Fourth Hospital of Hebei Medical University, Shijiazhuang,Hebei, China

Purpose/Objective(s): To evaluate the efficacy and safety of nimotuzumab combined with chemoradiotherapy versus chemoradiotherapy alone in the treatment of locally advanced and metastatic esophageal cancer.

Materials/Methods: We systematically searched the Cochrane Library, PubMed, Web of Science, VIP, Wanfang, and CNKI up to June 2025 using free-text terms and subject headings. Eligible studies consisted of controlled trials(RCTs) and cohort studies (RCS) comparing nimotuzumab plus chemoradiotherapy (Nimo group) with chemoradiotherapy alone (Non-Nimo group). Two investigators independently screened studies, extracted data, and assessed risk of bias. Statistical analyses were performed using Stata 17.0. Primary efficacy outcomes included objective response rate (ORR), disease control rate (DCR), and overall survival (OS), which were expressed as relative risk (RR) and hazard ratio (HR) with 95% confidence intervals (CI). Prespecified subgroup analyses were conducted by chemotherapy regimen (paclitaxel plus cisplatin [TP] versus fluorouracil plus cisplatin [FP]) and clinical stage (locally advanced).

Results:A total of 15 studies (7 RCTs, 8 cohort studies) involving 1,321 patients were included (Nimo group: n=606; Non-Nimo group: n=715). Squamous cell carcinoma accounted for 73.1% of histologically confirmed cases. Compared with the Non-Nimo group, the Nimo group demonstrated significantly improved ORR (RR=1.23, 95% CI 1.14-1.32, P<0.001) and DCR (RR=1.08, 95% CI 1.04-1.13, P<0.001), as well as prolonged overall survival with a 36% reduction in mortality risk (HR=0.64, 95% CI 0.51-0.80, P<0.001). No significant differences were observed in the incidence of grade adverse events between two groups, including hematologic toxicity, gastrointestinal reactions, radiation esophagitis, and treatment-related pneumonitis (all P>0.05). In subgroup analyses, the combination therapy with nimotuzumab showed superior ORR (TP: RR=1.19, 95% CI 1.09-1.29; FP: RR=1.35, 95% CI 1.16-1.57) and DCR (TP: RR=1.09, 95% CI 1.03-1.15; FP: RR=1.24, 95% CI 1.11-1.39) regardless of the chemotherapy regimen used. In locally advanced esophageal cancer, the nimotuzumab combination group also achieved superior efficacy(ORR :RR=1.29, 95% CI 1.14-1.46 ; DCR: RR=1.09, 95% CI 1.02-1.16).

Conclusion: For locally advanced and metastatic esophageal cancer, the addition of nimotuzumab to chemoradiotherapy improved short term efficacy and overall survival without a significant increase in treatment related toxicity.