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Real-world experience with anti-programmed cell death protein 1 immunotherapy in patients with esophageal cancer: A
Xinpeng Wang1,2, Lvjuan Cai1,2, Mengjing Wu1,2
1Department of Radiotherapy, The 900th Hospital of the Joint Logistics Team, Fujian Medical University, Fuzhou, China.
Abstract:
The "real-world" data of programmed cell death protein 1 (PD-1) inhibitors in esophageal cancer (EPC) are still an unmet medical need, including the clinical efficacy and safety. Seventy-seven EPC data were studied retrospectively; the progression-free survival (PFS), risk factors (clinical stages larger than stage II, metastatic sites larger than 2, treatment lines larger than the first line, previous surgical treatment, combined positive score [CPS] expression, etc.), and the safety were analyzed. The median PFS for all patients was 7.2 months, clinical stage > stage II; the number of treatment lines > first line was significantly correlated with prognosis (all P < 0.05). Subgroup analysis showed that the median PFS of patients with clinical stage ≤ II was better; the results were the same for the patients with ≤2 metastatic sites, first-line PD-1 inhibitors, and not previously received radical surgery (all P < 0.05). Meanwhile, the incidence of adverse events (AEs) of varying degrees was 25.97% (20/77) in 20 patients and 6.49% (5/77) of grade 3/4 AEs. The highest AE was myelosuppression (15.58%), followed by liver function injury (7.79%). In addition, ≥2 lines of treatment and >2 metastatic sites predicted poor outcomes for patients with EPC who had failed first-line therapy or progressed with the combined immunotherapy and chemotherapy treatment strategy (all P < 0.05).
Insights
Real-world data on programmed cell death protein 1 (PD-1) inhibitors in esophageal cancer (EPC) show a median progression-free survival (PFS) of 7.2 months. Early stage, fewer metastases, and first-line treatment predict better outcomes and safety.
Area of Science:
- Oncology
- Immunotherapy
- Gastrointestinal Cancers
Background:
- Real-world data on programmed cell death protein 1 (PD-1) inhibitors for esophageal cancer (EPC) are limited.
- Understanding clinical efficacy and safety is crucial for treatment optimization.
Purpose of the Study:
- To retrospectively analyze the clinical efficacy and safety of PD-1 inhibitors in a real-world EPC cohort.
- To identify prognostic factors influencing progression-free survival (PFS) and adverse events (AEs).
Main Methods:
- Retrospective analysis of 77 esophageal cancer patients treated with PD-1 inhibitors.
- Evaluation of progression-free survival (PFS), risk factors, and safety profiles.
- Subgroup analysis based on clinical stage, metastatic sites, treatment lines, and prior surgery.
Main Results:
- Median PFS was 7.2 months. Clinical stage > II and >1 treatment lines were significant negative prognostic factors (P < 0.05).
- Patients with stage ≤ II, ≤2 metastatic sites, first-line PD-1 inhibitors, and no prior surgery had better PFS (P < 0.05).
- Overall AE incidence was 25.97%, with grade 3/4 AEs at 6.49%. Myelosuppression and liver injury were most common.
Conclusions:
- PD-1 inhibitors demonstrate a median PFS of 7.2 months in real-world EPC. Favorable prognostic factors include early stage, limited metastatic burden, first-line use, and no prior surgery.
- Advanced stage, multiple metastatic sites, and prior treatments negatively impact outcomes.
- AEs are manageable, with myelosuppression and liver injury being notable concerns.
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