Analysis of camrelizumab in neoadjuvant chemotherapy for esophageal cancer: A retrospective cohort study

Neoadjuvant therapy has the potential to enhance the prognosis of esophageal squamous cell carcinoma (ESCC). Camrelizumab, a domestically developed programmed cell death protein 1 inhibitor in China, offers a convenient treatment option for Chinese patients with ESCC. The NIC-ESCC2019 trial has demonstrated that the combination of camrelizumab and neoadjuvant chemotherapy has favorable efficacy and tolerable toxicity for resectable ESCC. However, limited real-world comparative data exist regarding its efficacy and safety in Chinese patients with ESCC, necessitating further investigation. The present study aimed to evaluate the clinical efficacy and safety of camrelizumab in combination with paclitaxel and cisplatin for the neoadjuvant treatment of locally advanced ESCC. A retrospective analysis of clinical and pathological data was performed on 70 patients with locally advanced esophageal cancer who underwent neoadjuvant chemotherapy or chemo-immunotherapy followed by radical esophagectomy at Banan Hospital Affiliated to Chongqing Medical University from February 2021 to August 2023. Patients were divided into two groups based on treatment received: A control group (35 patients; neoadjuvant chemotherapy, paclitaxel + cisplatin) and an observation group (35 patients; camrelizumab + paclitaxel + cisplatin). Short-term efficacy, treatment-related adverse reactions (graded using Common Terminology Criteria for Adverse Events v5.0), and postoperative pathological complete remission (pCR) rate were compared. Baseline characteristics were comparable. The observation group had a significantly higher pCR rate compared with the control group (40.0 vs. 8.57%; P=0.002). All patients in the observation group achieved R0 resection, versus 32 (91.4%) in the control group. No grade ≥4 adverse events (AEs) occurred. Reactive cutaneous capillary endothelial proliferation was observed in 45.7% of the observation group (vs. 0% in controls; P<0.05), with no significant differences in other AEs (P>0.05). Neoadjuvant camrelizumab combined with paclitaxel and cisplatin may notably enhance pCR rates in locally advanced ESCC, with a manageable safety profile. The present findings suggest potential clinical benefit, but confirmation through prospective, randomized trials is essential to validate the regimen's efficacy and long-term outcomes.