Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China.
Thorac Cancer. 2022 Feb;13(3):497-501. doi: 10.1111/1759-7714.14279. Epub 2022 Jan 11.
Immune checkpoint inhibitors (ICIs) have been shown to improve survival in patients with advanced or metastatic esophageal cancer. However, ICI-based rechallenges after recovery from fatal adverse events (AEs) are equivocal, especially in patients who have already undergone treatment-related AEs. In this study, we report the case of a patient with advanced esophageal squamous cell cancer (ESCC) who developed a treatment-related tracheoesophageal fistula (TEF) after two cycles of ICI administration, provided in combination with traditional chemotherapeutics. After spontaneous healing of the TEF, the patient was again treated with ICIs and achieved a durable clinical response without any signs of fistula recurrence. Successful ICI-based rechallenges after fistula healing have rarely been reported. Therefore, ICI-based rechallenge in patients with esophageal cancer having an Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 after serious AEs may serve as a clinically viable treatment strategy that should be administered under close monitoring.
免疫检查点抑制剂 (ICIs) 已被证明可改善晚期或转移性食管癌患者的生存率。然而，在因致命不良事件 (AE) 恢复后基于 ICI 的再次治疗存在争议，特别是在已经发生治疗相关 AE 的患者中。在本研究中，我们报告了一例晚期食管鳞状细胞癌 (ESCC) 患者的病例，该患者在接受 ICI 联合传统化疗治疗两个周期后发生治疗相关的气管食管瘘 (TEF)。TEF 自发愈合后，患者再次接受 ICI 治疗，获得了持久的临床缓解，且没有瘘复发的迹象。瘘愈合后成功进行基于 ICI 的再次治疗的情况很少有报道。因此，对于 ECOG 体能状态 (PS) 0-1 的严重 AE 后发生食管癌症的患者，基于 ICI 的再次治疗可能是一种可行的治疗策略，应在密切监测下进行。
