Adding PD-1 inhibition to chemoradiotherapy for oesophageal cancer

In clinical practice, advances in immunotherapy have not yet reached patients with unresectable oesophageal squamous cell carcinoma treated with definitive chemoradiotherapy. The results of the single-arm, phase 2 EC-CRT-001 trial reported in The Lancet Oncology by Mian Xi and colleagues 1 Zhu Y Wen J Li Q et al. Toripalimab combined with definitive chemoradiotherapy in locally advanced oesophageal squamous cell carcinoma (EC-CRT-001): a single-arm, phase 2 trial. Lancet Oncol. 2023; 24: 371-382 Summary Full Text Full Text PDF Scopus (1) Google Scholar contribute to this field by investigating the addition of toripalimab, a PD-1 inhibitor, to definitive chemoradiotherapy. The primary endpoint, complete response after 3 months (based on endoscopy with biopsy and PET imaging), was met in 26 (62%; 95% CI 46–76) of 42 patients, which, in a post-hoc analysis, was significantly higher than the complete response rate of a propensity score-matched historical cohort (35 [42%] of 84 patients). Although comparison with a propensity score-matched cohort does not match the scientific rigour of a randomised study design, by reducing confounding and bias, propensity score matching can support the estimate of causal treatment effects for an observational study. Toripalimab combined with definitive chemoradiotherapy in locally advanced oesophageal squamous cell carcinoma (EC-CRT-001): a single-arm, phase 2 trialCombining toripalimab with definitive chemoradiotherapy provided encouraging activity and acceptable toxicity in patients with locally advanced oesophageal squamous cell carcinoma, and this regimen warrants further investigation. Full-Text PDF