Adjuvant Immunotherapy in Curative Intent Esophageal Cancer Resection Patients: Real-World Experience within an...

Area of Science:

• Oncology
• Immunotherapy
• Esophageal Cancer Research

Background:

• Clinical trials suggest adjuvant immunotherapy improves survival in esophageal cancer patients.
• This study examines the initial real-world experience with immunotherapy in an integrated health system.

Purpose of the Study:

• To evaluate the effectiveness and completion rates of adjuvant immunotherapy for esophageal cancer in a real-world setting.
• To compare outcomes of patients receiving immunotherapy versus those who did not.

Main Methods:

• Retrospective cohort study of patients undergoing minimally invasive esophagectomy (2017-2021).
• Assessment of treatment completion, adverse effects, and disease progression in the immunotherapy cohort.
• Specific focus on patients eligible for nivolumab in 2021.

Main Results:

• 39 patients received immunotherapy, 137 did not. Immunotherapy did not significantly impact 1-year overall survival.
• Only 18% of immunotherapy patients completed treatment due to progression or side effects.
• Of those eligible for nivolumab, 76.4% received it, but only 3 patients completed the full course.

Conclusions:

• Real-world adjuvant immunotherapy practice for esophageal cancer differs significantly from clinical trial results.
• High rates of treatment non-completion and lack of survival improvement were observed.
• Challenges exist in implementing immunotherapy regimens effectively in routine clinical care.