Clinical observation of anti-PD-1/PD-L1 immunotherapy plus concurrent chemoradiotherapy for locally advanced...

This study analyzed the efficacy of the PD-1 inhibitor Sintilimab combined with concurrent chemoradiotherapy (CCRT) in patients with unresectable locally advanced esophageal squamous cell carcinoma (ESCC).

A retrospective study involved 177 individuals with unresectable advanced ESCC, treated with anti-PD-1/PD-L1 immunotherapy combined with CCRT. Patients were categorized into three groups: combined positive score (CPS) ≥ 50, 1 < CPS < 50, and CPS < 1. Clinical data and laboratory markers (carcinoembryonic antigen [CEA] and squamous cell carcinoma antigen [SCC-Ag]) were collected at baseline, 6, 12, and 24 months. PET/CT and CT scans assessed tumor response, ORR, and DCR. Kaplan-Meier curves analyzed the impact of CPS scores on progression-free survival (PFS) and overall survival (OS). Baseline data were matched at a 1:1 ratio by propensity score matching, followed by Cox regression analyses.

No noticeable differences were present among the groups regarding gender, tumor location, prior chemotherapy, prior radiotherapy, or laboratory markers. After treatment, CEA and SCC-Ag levels significantly decreased, with the lowest levels observed at 24 months post-treatment. Higher CPS scores were associated with reduced CEA and SCC-Ag levels. PD-L1-positive groups (CPS > 1) had higher ORR and DCR than the PD-L1-negative group. As CPS scores increased, PFS and OS were significantly prolonged. Serum fibrinogen, CEA and SCC-Ag were identified as independent risk factors for OS; Serum CEA and SCC-Ag were independent risk factors affecting PFS.

Higher CPS scores are associated with improved PFS and OS in patients with locally advanced ESCC receiving anti-PD-1/PD-L1 immunotherapy combined with CCRT.