Neoadjuvant Therapy for Locally Advanced Esophageal Cancers

Huang, Run-Kai; Qiu, Zhicong; Zheng, Chunwen; Zeng, Ruijie; Chen, Wan-Xian; Wang, Simeng; Li, En‐Min; Xu, Yi‐Wei

doi:10.3389/fonc.2022.734581

Cited by 6 publications

(7 citation statements)

References 81 publications

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“…To improve clinical prognosis and outcomes, NAT has also been introduced to the treatment of EC, especially for patients with locally advanced EC. The primary neoadjuvant therapies (NATs) for EC are neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), and NAT combined with immunotherapy (60)(61)(62).…”

Section: Neoadjuvant Treatmentmentioning

confidence: 99%

“…Despite the widespread use of NAT in clinical practice, some drawbacks are hard to predict, including harmful toxic effects, outdated technology, and failure to address patients’ and hospitals’ actual requirements ( 25 , 73 ). Its future development still depends on individual characteristics and hospital technology, such as physical condition, pCR or recurrence prediction, and more multidisciplinary combination therapy ( 61 ). Noticeably, based on accurate assessment and prediction, the application of radiomics may help to reduce these deficiencies and prevent further complications of NAT in EC.…”

Section: Neoadjuvant Treatmentmentioning

confidence: 99%

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The application of radiomics in esophageal cancer: Predicting the response after neoadjuvant therapy

Guo

Tang

et al. 2023

Front. Oncol.

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Esophageal cancer (EC) is one of the fatal malignant neoplasms worldwide. Neoadjuvant therapy (NAT) combined with surgery has become the standard treatment for locally advanced EC. However, the treatment efficacy for patients with EC who received NAT varies from patient to patient. Currently, the evaluation of efficacy after NAT for EC lacks accurate and uniform criteria. Radiomics is a multi-parameter quantitative approach for developing medical imaging in the era of precision medicine and has provided a novel view of medical images. As a non-invasive image analysis method, radiomics is an inevitable trend in NAT efficacy prediction and prognosis classification of EC by analyzing the high-throughput imaging features of lesions extracted from medical images. In this literature review, we discuss the definition and workflow of radiomics, the advances in efficacy prediction after NAT, and the current application of radiomics for predicting efficacy after NAT.

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Section: Neoadjuvant Treatmentmentioning

confidence: 99%

Section: Neoadjuvant Treatmentmentioning

confidence: 99%

The application of radiomics in esophageal cancer: Predicting the response after neoadjuvant therapy

Guo

Tang

et al. 2023

Front. Oncol.

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“…Neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT) before surgery had a better prognosis than those who received surgery alone for patients with locally advanced esophageal cancer (LAEC) [4]. Based on a large number of clinical evidence [4][5][6][7][8], nCT or nCRT has been recommended as standard treatment in patients with LAEC [9]. However, although the prognosis of patients was improved to some extent, patients still faced the risk of cancer recurrence [9].…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant PD-1 blockade combined with chemotherapy is not superior to neoadjuvant chemotherapy alone in resectable locally advanced esophageal carcinoma

et al. 2023

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Background Neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy followed by surgery has been recommended as standard treatment in patients with locally advanced esophageal cancer (LAEC). But the risk of tumor recurrence still remained, and many patients refused or abandoned radiotherapy because of the intolerable adverse effects in China. Neoadjuvant immunochemotherapy (nICT) followed by surgery has become an emerging treatment in patients with esophageal cancer. There was still no consensus on whether nICT was superior to nCT alone in patients with esophageal cancer. Methods In this retrospective study, patients with resectable esophageal cancer who received surgery after nICT (n=26, 40%) or nCT alone (n=39, 60%) were included. The patients were classified as nICT or nCT arm. The primary endpoints were pathological tumor response (PTR) and event-free survival (EFS). The different clinic-pathological features were compared by the Kruskal-Wallis test for continuous variables and the Chi-square (χ2) test for categorical variables. Kaplan-Meier curves were used to estimate EFS from the date of treatment to recurrence or death. All tests were 2-sided with a significative P-value defined <.05. Results Three (11.5%) of the 26 patients achieved pathological complete remission (pCR) in the nICT group, and four (10.3%) of the 39 patients achieved pCR in the nCT group, respectively (P=1.000). Six (23.1%) of the 26 patients achieved major pathological response (MPR) in the nICT group, and 11 (28.2%) of the 39 patients achieved MPR in the nCT group, respectively (P=0.645). Downstaging was achieved in 13 (44.8%) patients in the nICT group and 16 (55.2%) patients in the nCT group, respectively (P=0.732). To verify the tumor regression grade (TRG) results, we compared them with MPR and pCR, which showed a significant dependency (P< 0.001). Patients who achieved downgrading showed better MPR and pCR rates (P<0.001 and P =0.010). There was no significant difference in EFS between the nICT and nCT groups (HR=1.011, 95% CI: 0.421–2.425, P = 0.981). Conclusions Neoadjuvant PD-1 blockade combined with chemotherapy was not superior to chemotherapy alone for patients with resectable locally advanced esophageal carcinoma. However, more studies with long-term follow-up were needed to confirm this result.

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“…With the recognition of tumor immunotherapy, the application of immune checkpoint inhibitors (ICIs) has gradually shifted from the back-line and second-line treatments to first-line and even perioperative treatments. PD-1/PD-L1 inhibitors have been approved to be used for the first-line treatment of advanced esophageal cancer, which significantly improves patient prognosis ( 7 ). The response rate of ICI alone in esophageal cancer varied from 9.9 to 33.3% in the reported studies ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Research trends on anti-PD-1/PD-L1 immunotherapy for esophageal cancer: A bibliometric analysis

Yang

Wang²

2022

Front. Oncol.

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ObjectivesThe study aims to summarize publication characteristics of anti-programmed cell death protein 1 (PD-1)/programmed cell death 1 ligand 1 (PD-L1) immunotherapy for esophageal cancer and create scientific maps to explore hotspots and emerging trends with bibliometric methods.MethodsThe publications between 2012 and 2021 were retrieved from the Web of Science Core Collection (WoSCC) on June 20, 2022. Bibliometric tools including HistCite, VOSviewer, and CiteSpace were used for statistical analysis. Data on the trend of the annual output, countries/regions, institutions, journals, authors, subject categories, keywords, and co-cited references were presented in this study.ResultsA total of 552 publications written by 3,623 authors of 872 institutions, 44 countries/regions in 250 journals were included in the bibliometric study. China, USA and Japan were the key countries in this field. Kato Ken, Bang Yung-Jue, Frontiers in Oncology, Journal of Clinical Oncology and Natl Canc Ctr were the top 1 productive author, co-cited author, productive journal, co-cited journal and prolific institution, respectively. The top 4 most present keywords were esophageal cancer, immunotherapy, esophageal squamous cell carcinoma and PD-L1. Neoadjuvant chemotherapy, response, PD-1 blockade and CD8+ T cell were four latest research frontiers. The keywords reflected the progress from PD-1/PD-L1 expression to the clinical application of PD-1/PD-L1 inhibitors. The current researches mainly focus on neoadjuvant immunotherapy for esophageal cancer and development of biomarkers. Further research is warranted to determine effective predictive biomarkers or models, illustrate the molecular mechanism of combined treatment, and construct the optimal therapeutic strategy.ConclusionsThis study visually analyzed the global trend and hotspots of anti-PD-1/PD-L1 immunotherapy for esophageal cancer over the past decade. The results could guide scientists to comprehensively understand the global frontiers and determine future directions.

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Neoadjuvant Therapy for Locally Advanced Esophageal Cancers

Cited by 6 publications

References 81 publications

The application of radiomics in esophageal cancer: Predicting the response after neoadjuvant therapy

The application of radiomics in esophageal cancer: Predicting the response after neoadjuvant therapy

Neoadjuvant PD-1 blockade combined with chemotherapy is not superior to neoadjuvant chemotherapy alone in resectable locally advanced esophageal carcinoma

Research trends on anti-PD-1/PD-L1 immunotherapy for esophageal cancer: A bibliometric analysis

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