Real-World Efficacy Data and Predictive Clinical Parameters for Treatment Outcomes in Advanced Esophageal Squamous Cell Carcinoma Treated with Immune Checkpoint Inhibitors
- Authors
- Kim, Jwa Hoon; Ahn, Bokyung; Hong, Seung-Mo; Jung, Hwoon-Yong; Kim, Do Hoon; Choi, Kee Don; Ahn, Ji Yong; Lee, Jeong Hoon; Na, Hee Kyoung; Kim, Jong Hoon; Kim, Yong-Hee; Kim, Hyeong Ryul; Lee, Hyun Joo; Kim, Sung-Bae; Park, Sook Ryun
- Issue Date
- Apr-2022
- Publisher
- 대한암학회
- Keywords
- Esophageal squamous cell carcinoma; Pembrolizumab; Nivolumab; Survival
- Citation
- Cancer Research and Treatment, v.54, no.2, pp 505 - 516
- Pages
- 12
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Cancer Research and Treatment
- Volume
- 54
- Number
- 2
- Start Page
- 505
- End Page
- 516
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/60732
- DOI
- 10.4143/crt.2020.1198
- ISSN
- 1598-2998
2005-9256
- Abstract
- Purpose
This study aimed to evaluate the real-world efficacy of immune checkpoint inhibitors (ICIs), and to identify clinicolaboratory factors to predict treatment outcomes in patients with advanced esophageal squamous cell carcinoma (ESCC) receiving ICIs.
Materials and Methods
Sixty patients with metastatic or unresectable ESCC treated with nivolumab (n=48) or pembrolizumab (n=12) as ≥ second-line treatment between 2016 and 2019 at Asan Medical Center were included.
Results
The median age of the patients was 68 years (range, 52 to 76 years), and 93.3% were male. Most patients had metastatic disease (81.7%) and had been previously treated with fluoropyrimidines, platinum, and taxane. In 53 patients with measurable disease, the overall response rate and disease control rate were 15.1% and 35.8%, respectively. With a median follow-up duration of 16.0 months, the median progression-free survival (PFS) and overall survival (OS) were 1.9 months (95% confidence interval [CI], 1.54 to 2.19) and 6.4 months (95% CI, 4.77 to 8.11), respectively. After multivariate analysis, recent use of antibiotics, low prognostic nutrition index (< 35.93), high Glasgow Prognosis Score (≥ 1) at baseline, and ≥ 1.4-fold increase in neutrophil-to-lymphocyte ratio after one cycle from baseline were significantly unfavorable factors for both PFS and OS. Younger age (< 65 years) was a significant factor for unfavorable PFS and hyponatremia (< 135 mmol/L) for unfavorable OS.
Conclusion
The use of ICIs after the failure of chemotherapy showed comparable efficacy in patients with advanced ESCC in real practice; this may be associated with host immune-nutritional status, which could be predicted by clinical and routine laboratory factors.
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Collections - 2. Clinical Science > Department of Medical Oncology and Hematology > 1. Journal Articles
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