New standard-of-care for locally advanced oesophageal squamous cell carcinoma?

Neoadjuvant camrelizumab plus chemotherapy increased pathologic complete response (pCR) rates compared with chemotherapy alone in patients with locally advanced oesophageal squamous cell carcinoma (LA-OSCC) in the phase 3 ESCORT-NEO trial. This regimen could become a new standard-of-care neoadjuvant treatment in patients with LA-OSCC.

The randomised, open-label, phase 3 ESCORT-NEO trial compared the efficacy and safety of neoadjuvant camrelizumab plus chemotherapy with chemotherapy alone in patients with resectable LA-OSCC. The participants (n=391) were randomised 1:1:1 to group A: camrelizumab plus albumin-bound paclitaxel and cisplatin; group B: camrelizumab plus paclitaxel and cisplatin; or group C: paclitaxel and cisplatin alone. The co-primary endpoints were event-free survival (EFS) and pCR. Prof. Yin Li (National Cancer Center, China) presented the results of the pCR analysis [1].

The pCR rates were 28.0%, 15.4%, and 4.7% in groups A, B, and C, respectively. Both group A (OR 8.11; 95% CI 3.28–20.06; P<0.0001) and group B (OR 3.81; 95% CI 1.48-9.80; P=0.0034) outperformed group C. “The study continues to mature for the co-primary endpoint of EFS,” added Prof. Li. Treatment-related adverse events of grade ≥3 occurred in 34.1%, 29.2%, and 28.8% of the participants in the respective arms of the study. Grade ≥3 immune-related toxicities were documented in 4.5% and 3.8% of the participants in groups A and B.

“Camrelizumab plus chemotherapy regimens displayed acceptable safety profiles and were more efficacious than chemotherapy alone,” Prof. Li summarised the findings. “Therefore, neoadjuvant camrelizumab plus chemotherapy may hold promise as a potential standard-of-care of the neoadjuvant treatment of patients with LA-OSCC.”

1. Li Y, et al. ESCORT-NEO/NCCES01: phase III study of camrelizumab plus chemotherapy versus chemotherapy as neoadjuvant treatment of resectable locally advanced esophageal squamous cell carcinoma. LBA244, ASCO Gastrointestinal Cancers Symposium 2024, 18–20 January, San Francisco, CA, USA.

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Posted on 13 February, 202427 March, 2024