転移性食道がんにおける免疫化学療法後の進行パターンに基づく精密治療による生存利益の最大化

This study aimed to define optimal treatment strategies for metastatic esophageal cancer with different progressive patterns after first-line immunotherapy (IO) resistance. Patients were stratified into oligoprogression and polyprogression, with further subclassifications (repeat oligoprogression [REO]/induced oligoprogression [INO]/de-novo polyprogression [DNP]/repeat polyprogression [REP]). Oligoprogression patients receiving radiotherapy (RT) had longer progression-free survival (PFS) (9.4 vs. 5.8 months, p = 0.018, q = 0.036) and overall survival (OS) (21.9 vs. 9.2 months, p = 0.012, q = 0.024), especially in the REO subgroup (PFS: 9.4 vs. 5.7 months, p = 0.0249, q = 0.0498; OS: 21.9 vs. 8.7 months, p = 0.018, q = 0.036). Polyprogression patients on IO rechallenge showed improved PFS (4.7 vs. 2.8 months, p = 0.006, q = 0.024) and OS (8.5 vs. 4.8 months, p = 0.001, q = 0.004), particularly in the REP subgroup (PFS: 5.6 vs. 2.8 months, p = 0.008, q = 0.016; OS: 5.6 vs. 2.8 months, p < 0.001, q < 0.002). Overall, RT is more important for patients with REO, while IO rechallenge could play a more dominant role for REP.