ESMO Immuno-Oncology Congress 2024

Abstract 83P

Background

This study aimed to retrospectively compare the effectiveness and safety of neoadjuvant immunochemotherapy with and without surgery for locally advanced esophageal squamous cell carcinoma (ESCC).

Methods

This study included patients with ESCC who received neoadjuvant immunochemotherapy from May 2021 to July 2023. Patients were divided into a surgery cohort and a non-surgery cohort. Outcomes included R0 resection rate, pathological complete response (pCR), major pathological response (MPR), objective response rate (ORR), event-free survival (EFS), overall survival (OS), and safety.

Results

Among the 61 patients undergoing neoadjuvant immunochemotherapy, 34 received subsequent surgery, and 27 did not undergo surgery due to unsuitability or refusal. Totally, 8 (13.1%) achieved complete response, and 37 (60.7%) had partial response, resulting in an overall ORR of 73.8%. In the surgery cohort, the R0 resection rate was 85.3% (29/34), with 23.5% (8/34) achieving pCR and 64.7% (22/34) achieving MPR. The EFS was 27.1 months (95% CI 16.0-NA) for the surgery cohort and 11.8 months (95% CI 6.1-17.1) for the non-surgery cohort. The 2-year OS rates were 92.8% (95% CI 74.0-98.2) and 74.6% (95% CI 41.5-90.7) in the surgery and non-surgery cohorts, respectively. Common adverse events included vomiting (70.5%), nausea (45.9%), and fatigue (19.7%). Common postoperative complications included anastomotic leakage (11.8%) and pulmonary infection (11.8%).

Conclusions

Neoadjuvant immunochemotherapy represents a promising treatment strategy for patients with locally advanced resectable ESCC, with high rates of R0 resection, pCR and MPR. The subsequent surgery leads to several postoperative complications which can be well-managed, and surgery contributes to improved survival.