Esophageal Squamous Cell Carcinoma (ESCC)
Conditions
Keywords
esophageal squamous cell cancer, neoadjuvant chemoradiotherapy, perioperative immunotherapy, PD-1 inhibitor
Brief summary
This study aims to examine the efficacy of the combination of neoadjuvant chemoradiotherapy and perioperative PD-1 inhibitor in patients with locally advanced esophageal squamous cell cancer and explore the predictive biomarkers for this regimen.
Interventions
RADIATIONNeoadjuvant Chemoradiotherapy
Neoadjuvant chemoradiotherapy: 1. Radiation dose: 1.8Gy/Fx, DT41.4Gy/23Fx. 2. Concurrent chemotherapy: Albumin-bound paclitaxel 60mg/m² + Cisplatin 25mg/m² on D1, D8, D15, D22, D29.
DRUGneoadjuvant immunotherapy
Begins on the second day after the completion of concurrent chemoradiotherapy, and no later than one week. Toripalimab 240mg Q3W, for a total of two cycles.
PROCEDURESurgery
Preoperative assessment is conducted 3 weeks after the last neoadjuvant immunotherapy, and surgery is performed within 4-6 weeks. All patients undergo minimally invasive radical esophagectomy, either McKeown or Ivor-Lewis, with extended two-field or three-field lymph node dissection.
Whether to undergo postoperative adjuvant immunotherapy is determined based on the pathological response. Patients with pCR are only observed without receiving adjuvant treatment, while those not reaching pCR receive one year of adjuvant Toripalimab.
Sponsors
RenJi Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* 18-75 years old * Histologically or cytologically confirmed esophageal squamous cell cancer * Stage T3-4aN0M0 or TanyN1-3M0 according to the American Joint Committee on Cancer staging manual eighth edition * Eastern Cooperative Oncology Group performance status of 0 or 1 * he indexes of hematology, biochemistry and organ function meet the following requirements: a. white blood cell count (WBC) ≥ 3.0×109/L；b. neutrophil count (ANC) ≥ 1.5×109/L; c. platelets ≥ 85×109/L; d. hemoglobin ≥ 90g/L; e. total bilirubin ≤ 1.5 ULN; f. ALT ≤ 1.5 ULN; g. creatinine clearance rate \>60 mL/min; * The cardiopulmonary function needs to meet the following criteria: EF ≥ 55%, VC \> 60%, FEV1 \> 1.2L, FEV1%\> 40%, DLco \> 40% * Women of childbearing age must undergo a pregnancy test within 7 days before enrollment for treatment, and only those with a negative result can be enrolled * Voluntarily participating in this study
Exclusion criteria
* Patients with active infection within 2 weeks before the first use of the study drug * A history of interstitial lung disease or non-infectious pneumonia * A history of autoimmune diseases or abnormal immune system * Patients who cannot tolerate chemoradiotherapy or surgery due to severe cardiac, lung dysfunction * Patients diagnosed with any other malignant tumor within 5 years before enrollment, except for malignant tumors with low risk of recurrence and risk of death, such as fully treated basal cell or squamous cell skin and carcinoma in situ of the cervix; * Known or suspected allergy or hypersensitivity to monoclonal antibodies, any ingredients of Toripalimab, and the chemotherapeutic drugs nab-paclitaxel or cisplatin * A history of immunodeficiency，including a positive HIV test result or other acquired or congenital immunodeficiency diseases, a history of organ transplantation or allogeneic bone marrow transplantation * Women during pregnancy or lactation * Other situations not suitable for enrollment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pathologically complete response(pCR) | From date of surgery to 4 weeks later | absence of viable tumor cells in the resected cancer specimen（ypT0N0） |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| event free survival | 24 months | From date of treatment until the date of death from any cause or the date of disease progression, assessed up to 24 months. |
Countries
China
Outcome results
None listed