Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis

BackgroundWe performed a network meta-analysis of phase III trials to compare the efficacy and safety of first-line regimens for patients with advanced esophageal squamous cell carcinoma (ESCC).MethodsA systematic review and Bayesian network meta-analysis were conducted by retrieving relevant litera...

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Main Authors: Chenglong Wang, Tongze Cai, Jiangcun Wei, Ying Huang, Lin Xiao, Tong Li, Zujie Qin
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1369848/full
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author Chenglong Wang
Chenglong Wang
Tongze Cai
Tongze Cai
Jiangcun Wei
Ying Huang
Lin Xiao
Tong Li
Tong Li
Zujie Qin
Zujie Qin
author_facet Chenglong Wang
Chenglong Wang
Tongze Cai
Tongze Cai
Jiangcun Wei
Ying Huang
Lin Xiao
Tong Li
Tong Li
Zujie Qin
Zujie Qin
author_sort Chenglong Wang
collection DOAJ
description BackgroundWe performed a network meta-analysis of phase III trials to compare the efficacy and safety of first-line regimens for patients with advanced esophageal squamous cell carcinoma (ESCC).MethodsA systematic review and Bayesian network meta-analysis were conducted by retrieving relevant literature from PubMed, Embase, the Cochrane Library, and the Web of Science. We included published sources of randomized clinical trials comparing immunotherapy combinations for treating advanced ESCC.ResultsWe analyzed seven studies involving eight immunotherapy combinations and 4688 patients. For patients without programmed death-ligand 1 (PD-L1) selection, it was found that the combination of toripalimab and chemotherapy provided better overall survival than chemotherapy alone (hazard ratio = 0.58, 95% confidence interval (CI) 0.43-0.78). Compared with chemotherapy alone, Sintilimab or camrelizumab plus chemotherapy seemed to achieve the best progression-free survival (hazard ratio = 0.56, 95% CI 0.46-0.68). Nivolumab plus chemotherapy appeared to provide the best objective response rate, with significant differences versus chemotherapy alone (odds ratio = 0.49, 95% CI 0.38-0.64). Nivolumab plus ipilimumab resulted in a relatively lower incidence of adverse events of grade ≥3 than other regimens.ConclusionsThe combination of immune checkpoint inhibitors (ICIs) with chemotherapy provided a high probability of more effective treatment in comparison with chemotherapy alone for patients with advanced ESCC. Toripalimab and sintilimab plus chemotherapy were ranked as providing the highest OS and PFS benefit in the first-line setting, respectively.
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publisher Frontiers Media S.A.
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spelling doaj-art-32afb463b1674206800d9652b2c5a47c2025-08-20T02:14:02ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-11-011410.3389/fonc.2024.13698481369848Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysisChenglong Wang0Chenglong Wang1Tongze Cai2Tongze Cai3Jiangcun Wei4Ying Huang5Lin Xiao6Tong Li7Tong Li8Zujie Qin9Zujie Qin10Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGraduate School, Guangxi University of Chinese Medicine, Nanning, ChinaGuangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGraduate School, Guangxi University of Chinese Medicine, Nanning, ChinaGuangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGuangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGuangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGuangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGraduate School, Guangxi University of Chinese Medicine, Nanning, ChinaGuangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, ChinaGraduate School, Guangxi University of Chinese Medicine, Nanning, ChinaBackgroundWe performed a network meta-analysis of phase III trials to compare the efficacy and safety of first-line regimens for patients with advanced esophageal squamous cell carcinoma (ESCC).MethodsA systematic review and Bayesian network meta-analysis were conducted by retrieving relevant literature from PubMed, Embase, the Cochrane Library, and the Web of Science. We included published sources of randomized clinical trials comparing immunotherapy combinations for treating advanced ESCC.ResultsWe analyzed seven studies involving eight immunotherapy combinations and 4688 patients. For patients without programmed death-ligand 1 (PD-L1) selection, it was found that the combination of toripalimab and chemotherapy provided better overall survival than chemotherapy alone (hazard ratio = 0.58, 95% confidence interval (CI) 0.43-0.78). Compared with chemotherapy alone, Sintilimab or camrelizumab plus chemotherapy seemed to achieve the best progression-free survival (hazard ratio = 0.56, 95% CI 0.46-0.68). Nivolumab plus chemotherapy appeared to provide the best objective response rate, with significant differences versus chemotherapy alone (odds ratio = 0.49, 95% CI 0.38-0.64). Nivolumab plus ipilimumab resulted in a relatively lower incidence of adverse events of grade ≥3 than other regimens.ConclusionsThe combination of immune checkpoint inhibitors (ICIs) with chemotherapy provided a high probability of more effective treatment in comparison with chemotherapy alone for patients with advanced ESCC. Toripalimab and sintilimab plus chemotherapy were ranked as providing the highest OS and PFS benefit in the first-line setting, respectively.https://www.frontiersin.org/articles/10.3389/fonc.2024.1369848/fullnetwork meta-analysisfirst-line immune checkpoint inhibitor combination therapiesadvanced esophageal squamous cell carcinomaefficacysafety
spellingShingle Chenglong Wang
Chenglong Wang
Tongze Cai
Tongze Cai
Jiangcun Wei
Ying Huang
Lin Xiao
Tong Li
Tong Li
Zujie Qin
Zujie Qin
Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis
Frontiers in Oncology
network meta-analysis
first-line immune checkpoint inhibitor combination therapies
advanced esophageal squamous cell carcinoma
efficacy
safety
title Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis
title_full Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis
title_fullStr Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis
title_full_unstemmed Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis
title_short Efficacy and safety of first-line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma: a network meta-analysis
title_sort efficacy and safety of first line immune checkpoint inhibitor combination therapies in patients with advanced esophageal squamous cell carcinoma a network meta analysis
topic network meta-analysis
first-line immune checkpoint inhibitor combination therapies
advanced esophageal squamous cell carcinoma
efficacy
safety
url https://www.frontiersin.org/articles/10.3389/fonc.2024.1369848/full
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