PMID- 36636044
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230115
IS  - 2078-6891 (Print)
IS  - 2219-679X (Electronic)
IS  - 2078-6891 (Linking)
VI  - 13
IP  - 6
DP  - 2022 Dec
TI  - Pembrolizumab combined with paclitaxel and platinum as induction therapy for 
      locally advanced esophageal squamous cell carcinoma: a retrospective, 
      single-center, three-arm study.
PG  - 2758-2768
LID - 10.21037/jgo-22-1196 [doi]
AB  - BACKGROUND: Pembrolizumab has been shown to have a powerful benefit for locally 
      advanced or metastatic esophageal cancer. The aim of present study was to 
      evaluate the efficacy and safety of pembrolizumab combined with neoadjuvant 
      chemotherapy for locally advanced and potentially resectable esophageal squamous 
      cell carcinoma (ESCC). METHODS: Patients diagnosed with clinical stage III-IV 
      ESCC and have a chance of resectability at Fujian Provincial Hospital were 
      included into this study. Patients received pembrolizumab in combination with 
      paclitaxel and nedaplatin as induction therapy once every 3 weeks in the first 
      stage. After 4 cycles of pembrolizumab therapy, the patients then chose to 
      undergo radical surgery (group A), radical radiotherapy (group B), or neither 
      (group C). In the third stage, maintenance treatment with pembrolizumab was 
      administered to all patients. RESULTS: A total of 39 patients (33 male and 6 
      female) with a median age of 64 years were included. After immune response 
      evaluation in the first stage, 34 (87.2%) patients achieved immune partial 
      response (iPR), and 5 (12.8%) patients achieved immune stable disease (iSD). The 
      objective response rate (ORR) was 87.2% (34/39), and the disease control rate 
      (DCR) was 100%. In the second stage, 22 patients received radical surgery, all of 
      whom achieved R0 resection. The major pathological response (MPR) rate was 68.2% 
      (15/22), and the pathological complete response (pCR) rate was 45.5% (10/22). Of 
      the patients, 9 chose radiotherapy as the radical therapeutic method and 8 chose 
      not to undergo any radical therapy. The median period of pembrolizumab therapy 
      was 8 cycles (4-22 cycles). The median follow-up time was 14 months (3-34 
      months). The median overall survival and progression-free survival (PFS) times 
      were not reached. The incidence of severe adverse events (AEs) (grade >/=3) was 
      15.4% (6/39). CONCLUSIONS: Pembrolizumab combined with paclitaxel and platinum 
      for locally advanced and potentially resectable ESCC has a high ORR, high 
      surgical conversion, MPR, pCR, and R0 resection rates, and tolerable AEs. Also, 
      pembrolizumab could provide good benefits in sequential treatment with radical 
      radiotherapy or maintenance therapy.
CI  - 2022 Journal of Gastrointestinal Oncology. All rights reserved.
FAU - Lin, Wenbao
AU  - Lin W
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
FAU - Huang, Yangyun
AU  - Huang Y
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
FAU - Zhu, Lihuan
AU  - Zhu L
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
FAU - Li, Wujin
AU  - Li W
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
FAU - Zhao, Lilan
AU  - Zhao L
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
FAU - Pan, Xiaojie
AU  - Pan X
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
FAU - Lin, Jinlan
AU  - Lin J
AD  - Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical 
      University, Fujian Cancer Hospital, Fuzhou, China.
FAU - Guo, Tianxing
AU  - Guo T
AD  - Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian 
      Medical University, Fujian Provincial Hospital, Fuzhou, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Gastrointest Oncol
JT  - Journal of gastrointestinal oncology
JID - 101557751
PMC - PMC9830331
OTO - NOTNLM
OT  - Pembrolizumab
OT  - efficacy
OT  - esophageal squamous cell carcinoma (ESCC)
OT  - immunotherapy
OT  - neoadjuvant
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jgo.amegroups.com/article/view/10.21037/jgo-22-1196/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2023/01/14 06:00
MHDA- 2023/01/14 06:01
PMCR- 2022/12/01
CRDT- 2023/01/13 01:54
PHST- 2022/11/11 00:00 [received]
PHST- 2022/12/07 00:00 [accepted]
PHST- 2023/01/13 01:54 [entrez]
PHST- 2023/01/14 06:00 [pubmed]
PHST- 2023/01/14 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - jgo-13-06-2758 [pii]
AID - 10.21037/jgo-22-1196 [doi]
PST - ppublish
SO  - J Gastrointest Oncol. 2022 Dec;13(6):2758-2768. doi: 10.21037/jgo-22-1196.