Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis

IntroductionImmunotherapy combined with chemotherapy is now the first-line standard for metastatic/recurrent esophageal cancer, with rapid immunotherapy advancements significantly improving patient outcomes. International guidelines recommend platinum-based combinations with either 5-fluorouracil or...

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Main Authors: Xiaochen Chen, Huiping Yan, Hongyang Zhao, Pengfei Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1607715/full
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author Xiaochen Chen
Xiaochen Chen
Huiping Yan
Hongyang Zhao
Pengfei Zhu
author_facet Xiaochen Chen
Xiaochen Chen
Huiping Yan
Hongyang Zhao
Pengfei Zhu
author_sort Xiaochen Chen
collection DOAJ
description IntroductionImmunotherapy combined with chemotherapy is now the first-line standard for metastatic/recurrent esophageal cancer, with rapid immunotherapy advancements significantly improving patient outcomes. International guidelines recommend platinum-based combinations with either 5-fluorouracil or paclitaxel as first-line treatments. Currently, no head-to-head studies directly compare fluorouracil and paclitaxel regimens in esophageal cancer.MethodsWe systematically searched online literature for clinical trials investigating first-line immunotherapy-chemotherapy combinations for esophageal cancer. Data were analyzed using Review Manager (RevMan) 5.3 software, with pooled results expressed as odds ratios (ORs) and 95% confidence intervals (CIs).ResultsBoth paclitaxel- and fluorouracil-based immunotherapy combinations demonstrated clinical benefits in overall survival, progression-free survival, and objective response rates. Notably, paclitaxel-based immunotherapy significantly increased ORR compared to fluorouracil-based regimens (OR 2.61 vs 1.58).DiscussionOur findings suggest that paclitaxel-immunotherapy combinations may offer enhanced disease control compared to fluorouracil-based approaches, warranting further studies to identify optimal patient populations and refine treatment strategies.
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spelling doaj-art-e0d96108c8bc4ff48feb100254ec1e6c2025-08-20T03:39:26ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16077151607715Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysisXiaochen Chen0Xiaochen Chen1Huiping Yan2Hongyang Zhao3Pengfei Zhu4Cancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, ChinaDepartment of Medical Oncology, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, Guizhou, ChinaCancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, ChinaCancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, ChinaCancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, ChinaIntroductionImmunotherapy combined with chemotherapy is now the first-line standard for metastatic/recurrent esophageal cancer, with rapid immunotherapy advancements significantly improving patient outcomes. International guidelines recommend platinum-based combinations with either 5-fluorouracil or paclitaxel as first-line treatments. Currently, no head-to-head studies directly compare fluorouracil and paclitaxel regimens in esophageal cancer.MethodsWe systematically searched online literature for clinical trials investigating first-line immunotherapy-chemotherapy combinations for esophageal cancer. Data were analyzed using Review Manager (RevMan) 5.3 software, with pooled results expressed as odds ratios (ORs) and 95% confidence intervals (CIs).ResultsBoth paclitaxel- and fluorouracil-based immunotherapy combinations demonstrated clinical benefits in overall survival, progression-free survival, and objective response rates. Notably, paclitaxel-based immunotherapy significantly increased ORR compared to fluorouracil-based regimens (OR 2.61 vs 1.58).DiscussionOur findings suggest that paclitaxel-immunotherapy combinations may offer enhanced disease control compared to fluorouracil-based approaches, warranting further studies to identify optimal patient populations and refine treatment strategies.https://www.frontiersin.org/articles/10.3389/fonc.2025.1607715/fullchemotherapyimmunotherapyesophageal cancermeta-analysispaclitaxelfluorouracil
spellingShingle Xiaochen Chen
Xiaochen Chen
Huiping Yan
Hongyang Zhao
Pengfei Zhu
Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis
Frontiers in Oncology
chemotherapy
immunotherapy
esophageal cancer
meta-analysis
paclitaxel
fluorouracil
title Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis
title_full Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis
title_fullStr Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis
title_full_unstemmed Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis
title_short Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: fluorouracil or paclitaxel? – a meta-analysis
title_sort application of chemotherapy combined with immunotherapy in first line treatment of advanced esophageal cancer fluorouracil or paclitaxel a meta analysis
topic chemotherapy
immunotherapy
esophageal cancer
meta-analysis
paclitaxel
fluorouracil
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1607715/full
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