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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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-08-01
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| 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. |
| format | Article |
| id | doaj-art-e0d96108c8bc4ff48feb100254ec1e6c |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| 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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