医学
福克斯
阿替唑单抗
奥沙利铂
围手术期
新辅助治疗
内科学
肿瘤科
食管切除术
化疗
腺癌
临床研究阶段
食管癌
外科
胃肠病学
免疫疗法
癌症
结直肠癌
彭布罗利珠单抗
乳腺癌
作者
Matheus Sewastjanow-Silva,Lianchun Xiao,Graciela M. Nogueras‐González,Xuemei Wang,Wayne L. Hofstetter,Stephen G. Swisher,Reza J. Mehran,Boris Sepesi,Manoop S. Bhutani,Brian Weston,Emmanuel Coronel,Rebecca Waters,Jane E. Rogers,Jackie Smith,L. R. Lyons,Norelle R. Reilly,James C. Yao,Jaffer A. Ajani,Mariela Blum Murphy
出处
期刊:Cancers
[MDPI AG]
日期:2024-03-31
卷期号:16 (7): 1378-1378
标识
DOI:10.3390/cancers16071378
摘要
Efforts to improve the prognosis for patients with locally advanced esophageal or gastroesophageal junction (GEJ) adenocarcinoma have focused on neoadjuvant approaches to increase the pathological complete response (pathCR) rate, improve surgical resection, and prolong event-free and overall survival (OS). Building on the recent evidence that PD-1 inhibition plus chemotherapy improves the OS of patients with metastatic GEJ adenocarcinoma, we evaluated whether the application of this strategy in the neoadjuvant setting would improve the pathological response. This single-center phase I/II trial evaluated the safety, toxicity, and efficacy of neoadjuvant atezolizumab with oxaliplatin and 5-fluorouracil (modified FOLFOX) followed by esophagectomy followed by atezolizumab. The primary objective goal was to achieve 20% pathCR. From the twenty enrolled patients, eighteen underwent resection and two (10%, 95% CI: 1.24–31.7%) achieved pathCR. After a median follow-up duration of 40.7 months, 11 patients had disease recurrence and 10 had died. The median disease-free and OS were 28.8 (95% CI: 14.7, NA) and 38.6 months (95% CI: 30.5, NA), respectively. No treatment-related adverse events led to death. Although modified FOLFOX plus atezolizumab did not achieve the expected pathCR, an acceptable safety profile was observed. Our results support the continued development of a more refined strategy (neoadjuvant chemotherapy plus perioperative immunotherapy/targeted agents) with molecular/immune profiling in parallel.
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