ABSTRACT

Introduction: Esophageal cancer (EC) is the seventh most common cancer and the sixth leading cause of cancer death worldwide. The prognosis for advanced EC patients remains poor and there are few effective therapeutic agents available. Nivolumab is a fully human IgG4 monoclonal antibody that exerts antitumor activity by inhibiting the interaction of programmed cell death protein 1 on activated lymphocytes with its ligands. Nivolumab monotherapy showed significant benefit for overall survival of patients with advanced esophageal squamous cell carcinoma (ESCC) relative to taxane as a second-line treatment. Additionally, adjuvant nivolumab monotherapy showed significant disease-free survival benefit relative to placebo for resectable EC patients with residual pathologic disease who had received neoadjuvant chemoradiotherapy followed by surgery.

Areas covered: Here, we provide an overview of checkpoint blockade with nivolumab and present the available clinical data related to its use in EC.

Expert opinion: Nivolumab should be the standard second-line treatment for advanced ESCC patients and possibly adjuvant treatment of choice after neoadjuvant chemoradiotherapy followed by surgery. Trials assessing efficacy of a combination of cytotoxic agents and nivolumab as first-line treatment, nivolumab-containing chemoradiotherapy, and neoadjuvant chemotherapy are ongoing. These trials should result in improved protocols for better clinical outcomes in EC.

摘要

介绍: 食道癌 (EC) 是全球第七大常见癌症和第六大癌症死亡原因。晚期 EC 患者的预后仍然很差，可用的有效治疗药物很少。Nivolumab 是一种全人源 IgG4 单克隆抗体，通过抑制活化淋巴细胞上的程序性细胞死亡蛋白 1 与其配体的相互作用来发挥抗肿瘤活性。与紫杉烷作为二线治疗相比，Nivolumab 单药治疗对晚期食管鳞状细胞癌 (ESCC) 患者的总生存期有显着益处。此外，对于接受新辅助放化疗后手术的可切除EC患者，与安慰剂相比，辅助纳武利尤单抗单药治疗显示出显着的无病生存获益。

涵盖的领域：在这里，我们概述了使用 nivolumab 阻断检查点，并提供了与其在 EC 中使用相关的可用临床数据。

专家意见：纳武利尤单抗应该是晚期 ESCC 患者的标准二线治疗，并且可能是新辅助放化疗后手术后的辅助治疗选择。评估细胞毒性药物和纳武利尤单抗联合作为一线治疗、含纳武利尤单抗的放化疗和新辅助化疗疗效的试验正在进行中。这些试验应该会导致改进方案，以获得更好的 EC 临床结果。