Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study

The potential benefits of adding immune checkpoint inhibitors (ICIs) to definitive chemoradiotherapy (dCRT) for inoperable esophageal squamous cell carcinoma (ESCC) remain unclear, different timing for immunotherapy intervention during the peri-dCRT period on survival outcomes is worth exploring. Pa...

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Main Authors: Xiongtao Yang, Xiaomin Wang, Qin Xiao, Xiaolin Ge, Nuo Yu, Jiao Li, Guojie Feng, Ziyu Zheng, Yingying Jiang, Lin Lu, Xiaojie Xia, Lei Deng, Tao Zhang, Wenqing Wang, Wenyang Liu, Jianyang Wang, Zefen Xiao, Zongmei Zhou, Nan Bi, Hui Wang, Cheng Chen, Xin Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Cancer Biology & Therapy
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Online Access:https://www.tandfonline.com/doi/10.1080/15384047.2025.2504726
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author Xiongtao Yang
Xiaomin Wang
Qin Xiao
Xiaolin Ge
Nuo Yu
Jiao Li
Guojie Feng
Ziyu Zheng
Yingying Jiang
Lin Lu
Xiaojie Xia
Lei Deng
Tao Zhang
Wenqing Wang
Wenyang Liu
Jianyang Wang
Zefen Xiao
Zongmei Zhou
Nan Bi
Hui Wang
Cheng Chen
Xin Wang
author_facet Xiongtao Yang
Xiaomin Wang
Qin Xiao
Xiaolin Ge
Nuo Yu
Jiao Li
Guojie Feng
Ziyu Zheng
Yingying Jiang
Lin Lu
Xiaojie Xia
Lei Deng
Tao Zhang
Wenqing Wang
Wenyang Liu
Jianyang Wang
Zefen Xiao
Zongmei Zhou
Nan Bi
Hui Wang
Cheng Chen
Xin Wang
author_sort Xiongtao Yang
collection DOAJ
description The potential benefits of adding immune checkpoint inhibitors (ICIs) to definitive chemoradiotherapy (dCRT) for inoperable esophageal squamous cell carcinoma (ESCC) remain unclear, different timing for immunotherapy intervention during the peri-dCRT period on survival outcomes is worth exploring. Patients with inoperable ESCC receiving dCRT combined with ICIs between April 2018 and April 2022 were recruited from five hospitals in China. A historical control group treated with dCRT alone was used for comparison. Stabilized inverse probability of treatment weights (sIPTW) analyses were conducted to compare survival. The survival outcomes and treatment-related adverse effects were analyzed. A total of 290 patients with inoperable ESCC who received dCRT+ICI treatment were analyzed. The median follow-up was 35.7 months. The 1-year and 2-year overall survival (OS) rates were 86.7% and 66.9%, respectively, and the 1-year and 2-year progression-free survival (PFS) rates were 66.7% and 47.3%, respectively. The median PFS was 22.4 months, and the median OS was not reached. The dCRT+ICI group had significantly longer OS than the historical control group (2-year OS: 66.9% vs. 56.5%, for sIPTW-adjusted data: HR = 0.62, p < .001). After sIPTW, no differences in OS were found among the induction, concurrent, and consolidation groups. The sIPTW-adjusted analysis showed that both the induction and concurrent groups had significantly longer PFS than the consolidation group. Combining immunotherapy with dCRT improved survival outcomes and demonstrated a favorable safety profile in patients with inoperable ESCC. Induction or concurrent immunotherapy may provide superior survival benefits compared to consolidation immunotherapy.Trial registration Trial no. NCT04821778 registered in ClinicalTrials.gov
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spelling doaj-art-7cacfca496f4422fb75f0d21065e67d42025-08-20T03:49:31ZengTaylor & Francis GroupCancer Biology & Therapy1538-40471555-85762025-12-0126110.1080/15384047.2025.2504726Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world studyXiongtao Yang0Xiaomin Wang1Qin Xiao2Xiaolin Ge3Nuo Yu4Jiao Li5Guojie Feng6Ziyu Zheng7Yingying Jiang8Lin Lu9Xiaojie Xia10Lei Deng11Tao Zhang12Wenqing Wang13Wenyang Liu14Jianyang Wang15Zefen Xiao16Zongmei Zhou17Nan Bi18Hui Wang19Cheng Chen20Xin Wang21Department of Oncology, Beijing Changping Hospital, Beijing, ChinaDepartment 1st of Radiation Oncology, Anyang Cancer Hospital, Anyang, Henan, ChinaDepartment of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, ChinaDepartment of Radiation Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Oncology, Province Geriatric Hospital, Nanjing, Jiangsu, ChinaDepartment of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, ChinaDepartment of Radiation Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, ChinaDepartment of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, ChinaDepartment of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaThe potential benefits of adding immune checkpoint inhibitors (ICIs) to definitive chemoradiotherapy (dCRT) for inoperable esophageal squamous cell carcinoma (ESCC) remain unclear, different timing for immunotherapy intervention during the peri-dCRT period on survival outcomes is worth exploring. Patients with inoperable ESCC receiving dCRT combined with ICIs between April 2018 and April 2022 were recruited from five hospitals in China. A historical control group treated with dCRT alone was used for comparison. Stabilized inverse probability of treatment weights (sIPTW) analyses were conducted to compare survival. The survival outcomes and treatment-related adverse effects were analyzed. A total of 290 patients with inoperable ESCC who received dCRT+ICI treatment were analyzed. The median follow-up was 35.7 months. The 1-year and 2-year overall survival (OS) rates were 86.7% and 66.9%, respectively, and the 1-year and 2-year progression-free survival (PFS) rates were 66.7% and 47.3%, respectively. The median PFS was 22.4 months, and the median OS was not reached. The dCRT+ICI group had significantly longer OS than the historical control group (2-year OS: 66.9% vs. 56.5%, for sIPTW-adjusted data: HR = 0.62, p < .001). After sIPTW, no differences in OS were found among the induction, concurrent, and consolidation groups. The sIPTW-adjusted analysis showed that both the induction and concurrent groups had significantly longer PFS than the consolidation group. Combining immunotherapy with dCRT improved survival outcomes and demonstrated a favorable safety profile in patients with inoperable ESCC. Induction or concurrent immunotherapy may provide superior survival benefits compared to consolidation immunotherapy.Trial registration Trial no. NCT04821778 registered in ClinicalTrials.govhttps://www.tandfonline.com/doi/10.1080/15384047.2025.2504726Immunotherapydefinitive chemoradiotherapyinoperable esophageal cancerreal-world studyPD-L1
spellingShingle Xiongtao Yang
Xiaomin Wang
Qin Xiao
Xiaolin Ge
Nuo Yu
Jiao Li
Guojie Feng
Ziyu Zheng
Yingying Jiang
Lin Lu
Xiaojie Xia
Lei Deng
Tao Zhang
Wenqing Wang
Wenyang Liu
Jianyang Wang
Zefen Xiao
Zongmei Zhou
Nan Bi
Hui Wang
Cheng Chen
Xin Wang
Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study
Cancer Biology & Therapy
Immunotherapy
definitive chemoradiotherapy
inoperable esophageal cancer
real-world study
PD-L1
title Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study
title_full Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study
title_fullStr Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study
title_full_unstemmed Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study
title_short Definitive chemoradiotherapy combined with anti-PD-1 immunotherapy for inoperable esophageal squamous cell carcinoma: a multicenter real-world study
title_sort definitive chemoradiotherapy combined with anti pd 1 immunotherapy for inoperable esophageal squamous cell carcinoma a multicenter real world study
topic Immunotherapy
definitive chemoradiotherapy
inoperable esophageal cancer
real-world study
PD-L1
url https://www.tandfonline.com/doi/10.1080/15384047.2025.2504726
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