Keywords
Neoadjuvant chemoradiotherapy
Immunotherapy
Neoadjuvant chemotherapy
Submitted : 2023-08-27
Accepted : 2023-09-11
Published : 2023-09-26
Abstract
Abstract: Esophageal cancer is one of the common malignant tumors in China with a high mortality rate. Neoadjuvant chemoradiotherapy (nRCT) is currently the primary treatment method for locally advanced esophageal cancer. However, nRCT has not been not widely applied in China due to several reasons. First, the radiotherapy equipment and technology vary in different regions, and the learning curve for these technologies is steep, making rapid implementation difficult. Furthermore, the combined toxicity of radiotherapy and chemotherapy can counteract the survival benefits of preoperative treatment. In recent years, a promising approach involves combining neoadjuvant chemotherapy with immunotherapy for patients with locally advanced esophageal cancer. This article offers an overview of the progress in neoadjuvant therapy for this condition.
References
Sung H, Ferlay J, Siegel RL, et al., 2021, Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and
Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin, 71(3): 209–249.
Thun M, Linet MS, Cerhan JR, et al., 2018, Cancer Epidemiology and Prevention, 4th Edition Oxford University
Press, New York.
McCormack VA, Menya D, Munishi MO, et al., 2017, Informing Etiologic Research Priorities for Squamous Cell
Esophageal Cancer in Africa: A Review of Setting-Specific Exposures to Known and Putative Risk Factors. Int J
Cancer, 140(2): 259–271.
Mao YS, Gao SG, Wang Q, et al., 2020, Analysis of a Registry Database For Esophageal Cancer from
High-Volume Centers in China. Dis Esophagus, 33: doz091.
Liu S, Wen J, Yang H, et al., 2020, Recurrence Patterns After Neoadjuvant Chemoradiotherapy Compared
With Surgery Alone in Oesophageal Squamous Cell Carcinoma: Results from the Multicenter Phase III Trial
NEOCRTEC5010. Eur J Cancer, 138: 113–121.
Ten-Year Outcome of Neoadjuvant Chemoradiotherapy Plus Surgery for Esophageal Cancer: The Randomized
Controlled CROSS Trial. J Clin Oncol, 2021, 39(18): 1995–2004.
Yang H, Liu H, Chen Y, et al., 2021, Long-term Efficacy of Neoadjuvant Chemoradiotherapy Plus Surgery for the
Treatment of Locally Advanced Esophageal Squamous Cell Carcinoma: The NEOCRTEC5010 Randomized Clinical
Trial. JAMA Surg, 156(8): 721–729.
Wang H, Tang H, Fang Y, et al., 2021, Morbidity and Mortality of Patients Who Underwent Minimally Invasive
Esophagectomy After Neoadjuvant Chemoradiotherapy vs Neoadjuvant Chemotherapy for Locally Advanced
Esophageal Squamous Cell Carcinoma: A Randomized Clinical Trial. JAMA Surg, 156(5): 444–451.
Zhang G, Zhang C, Sun N, et al., 2021, Neoadjuvant Chemoradiotherapy Versus Neoadjuvant Chemotherapy for the
Treatment of Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Study from the National Cancer
Center in China. J Cancer Res Clin Oncol, 143: 943–945.
Tang H, Zheng H, Tan L, et al., 2018, Neoadjuvant Chemoradiotherapy Followed By Minimally Invasive
Esophagectomy: Is it a Superior Approach for Locally Advanced Resectable Esophageal Squamous Cell Carcinoma?.
J Thorac Dis, 10(2): 963–972.
Kelly RJ, Smith KN, Anagnostou V, et al., 2019, Neoadjuvant Nivolumab Plus Concurrent Chemoradiation in
Stage II/III Esophageal/Gastroesophageal Junction Cancer [Abstract]. J Clin Oncol, 37(4 suppl): 142.
Cheng C, Yang W, Chen W, et al., 2021, Neoadjuvant PD-1 Blockade in Combination with Chemotherapy for
Patients with Resectable Esophageal Squamous Cell Carcinoma [Abstract]. J Clin Oncol, 39(3 suppl): 220.
Lee S, Ahn BC, Park SY, et al., 2019, A Phase II Trial of Preoperative Chemoradiotherapy and Pembrolizumab for
Locally Advanced Esophageal Squamous Cell Carcinoma (ESCC). Ann Oncol, 30(Suppl 4): v754.
Li C, Zhao S, Zheng Y, et al., 2021, Preoperative pembrolizumab combined with chemoradiotherapy for oesophageal
squamous cell carcinoma (PALACE-1). Eur J Cancer, 144: 232–241.
Kelly RJ, Ajani JA, Kuzdzal J, et al., 2020, LBA9_PR Adjuvant Nivolumab in Resected Esophageal or
Gastroesophageal Junction Cancer (EC/GEJC) Following Neoadjuvant Chemoradiation Therapy (CRT): First
Results of the CheckMate 577 study. Ann Oncol, 31(Suppl 4): S1193–S1194.
Sun JM, Shen L, Shah MA, et al., 2021, Pembrolizumab Plus Chemotherapy Versus Chemotherapy Alone for FirstLine Treatment of Advanced Oesophageal Cancer (KEYNOTE-590): A Randomised, Placebo-Controlled, Phase 3
Study. Lancet, 398(10302): 759–771.
Yamamoto S, Kato K, Daiko H, et al., 2020, Feasibility Study of Nivolumab as Neoadjuvant Chemotherapy for
Locally Esophageal Carcinoma: FRONTiER (JCOG1804E). Future Oncol, 16(19): 1351–1357.
Li K, Yang X, Luo W, et al., 2020, 415 Toripalimab Plus Nab-Paclitaxel and Carboplatin as Neoadjuvant Therapy
for Patients with Esophageal Squamous Cell Carcinoma at Clinical Stage T2-T4/N0-N2/M0: A Single-Arm,
Single-Center Clinical Study J I [Abstract]. Immunother Cancer, 8(Suppl 3): A253.
Gu Y, Chen X, Wang D, et al., 2020, A Study of Neoadjuvant Sintilimab Combined with Triplet Chemotherapy
of Lipopaclitaxel, Cisplatin, and S-1 For Resectable Esophageal Squamous Cell Carcinoma (ESCC).Ann Oncol,
(Suppl 4): S1307–S1308.
Liu J, Li Z, Fu X, et al., 2020, A Prospective Phase II Clinical Trial Exploring Neoadjuvant Immunotherapy
Combined with Chemotherapy in Resectable Thoracic Esophageal Squamous Cell Cancer (TESCC) with MultiStation Lymph Node Metastases (NICE study): Preliminary Results [Abstract]. Ann Oncol, 31(Suppl 4): S1292.
Wang F, Qi Y, Meng X, et al., 2021, Camrelizumab in Combination with Preoperative Chemotherapy for Locally
Advanced Esophageal Squamous Cell Carcinoma: A Single-Arm, Open-Label, Phase II Study [Abstract]. J Clin
Oncol, 39(Suppl 3): 222.