Background: The aim of this study was to evaluate whether the efficacy and safety of PD-1 inhibitors combined with chemotherapy in the treatment of patients with esophageal squamous cell carcinoma ESCC with distant metastasis in the real world are as effective and safe as in clinical trials. Patients and methods: From July to July , a total of patients with distant metastasis of ESCC were included and divided into the PD-1 inhibitor combined chemotherapy group PC group and the chemotherapy alone group C group according to the treatment regimen.
There were patients in the PC group and patients in the C group. The combination of PD-1 inhibitors with cisplatin and paclitaxel TP was more beneficial for patients with PFS compared to the combination of cisplatin and fluorouracil PF.
Furthermore, the presence of bone metastasis, body mass index BMI , and lymphocyte-to-monocyte ratio LWR before treatment may be potential predictive factors for patient OS. The adverse reactions that occurred in the PC group can be tolerated or alleviated after both prevention and active treatment. Conclusions: The combination of PD-1 inhibitors and chemotherapy as first-line treatment for ESCC patients with distant metastasis still has good efficacy and safety compared to clinical trials in the real world.
Esophageal cancer is a common gastrointestinal tumor, the seventh most common cancer, and the sixth most common cause of cancer-related death globally 1. More than two-thirds of esophageal cancer patients are diagnosed with advanced or metastatic disease 2. Esophageal cancer consists of two main histological types, including esophageal squamous cell carcinoma ESCC and esophageal adenocarcinoma EAC.
The clinical benefits are still limited, and the median overall survival OS of patients is generally around one year, with no further breakthroughs 4 β 6. Multiple clinical trials have shown that PD-1 inhibitors in immunotherapy drugs have good clinical efficacy in the first-line treatment of advanced esophageal cancer 7 β In addition, the median OS was nearly 3 months longer in all randomized patients According to the findings of this study, pembrolizumab became the first PD-1 inhibitor approved for the first-line treatment of advanced esophageal cancer, breaking the bottleneck period for advanced ESCC treatment 7.
