ESMO Asia Congress 2022

Abstract 113P

Background

Brain metastases (BRMs) from esophageal squamous cell carcinoma (ESCC) is clinically rare and has not yet been reported in patients who have received immunotherapy. This study aimed to investigate the clinicopathological characteristics of BRMs in ESCC patients who have received neoadjuvant immunotherapy plus chemotherapy, in order to provide guidance for clinical practice.

Methods

We analyzed 76 patients from our cancer registry suffering from ESCC and treated at Shanghai Chest Hospital between June 2019 and June 2022 for the presence of BRMs.

Results

From 76 ESCC patients who have received neoadjuvant immunotherapy plus chemotherapy, pathologically complete response (pCR) was identified in 32 (42.1%) patients. We found 5 patients with BRMs among them, resulting in an incidence of 6.6%. BRMs are more frequent in pCR patients (12.5% vs 2.3%, p<0.05). Mean duration for the onset of BRMs from initial immunotherapy was 300 days (127-542days). Among the 5 patients with BMs, four of them presented with single lesion BMs and only 1 patient was diagnosed with multiple BMs，four of them did not exhibit any extracranial metastases when diagnosed with BMs. All of them received brain radiotherapy, 4 with stereotactic radiosugery and 1 with whole brain radiotherapy.

Conclusions

In this single-center retrospective study, brain metastases (BRMs) occurred with a high frequency (6.6%) in ESCC who have received neoadjuvant immunotherapy plus chemotherapy, significantly more often in pCR patients. Our observations suggest the need for further prospective trials to validate our hypothesis and ultimately the implementation of routine screening procedures to detect asymptomatic brain metastases.