Department of Radiation Oncology, Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China.
College of Management, Sichuan Agricultural University, Chengdu, P.R. China.
Expert Rev Clin Immunol. 2024 Aug;20(8):971-984. doi: 10.1080/1744666X.2024.2368194. Epub 2024 Jun 17.
Esophageal cancer (EC), particularly esophageal squamous cell carcinoma (ESCC), is characterized by high incidence and poor prognosis worldwide, necessitating novel therapeutic approaches like immunotherapy. This review explores the impact of immune checkpoint inhibitors (ICIs) on ESCC, especially focusing on PD-1/PD-L1 and CTLA-4 inhibitors. Our literature search, conducted across databases including PubMed, Web of Science, and EMBASE, from January 2010 to December 2023, aimed at identifying advancements, challenges, and future directions in the use of immunotherapy for ESCC.
We provide a detailed analysis of clinical trials evaluating the efficacy of ICIs as monotherapy and in combination with chemotherapy, radiotherapy, and targeted therapy for locally advanced ESCC. Our findings highlight the significant survival benefits offered by ICIs, albeit with varying efficacy across patient populations, emphasizing the need for precise biomarkers to tailor treatment strategies.
The integration of immunotherapy into the ESCC treatment paradigm represents a significant shift, improving survival outcomes. Future research should focus on optimizing combination therapies and novel immunotherapeutic agents, incorporating genetic and tumor microenvironment analyses to enhance patient selection and treatment efficacy.
食管癌（EC），特别是食管鳞状细胞癌（ESCC），在全球范围内具有发病率高和预后差的特点，需要新的治疗方法，如免疫疗法。本综述探讨了免疫检查点抑制剂（ICIs）对 ESCC 的影响，特别是针对 PD-1/PD-L1 和 CTLA-4 抑制剂。我们的文献检索在 2010 年 1 月至 2023 年 12 月期间在包括 PubMed、Web of Science 和 EMBASE 在内的数据库中进行，旨在确定免疫疗法在 ESCC 中的应用的进展、挑战和未来方向。
我们对评估 ICIs 单药治疗和联合化疗、放疗和靶向治疗局部晚期 ESCC 的疗效的临床试验进行了详细分析。我们的研究结果强调了 ICIs 提供的显著生存获益，尽管在不同患者群体中疗效存在差异，强调需要精确的生物标志物来制定治疗策略。
免疫疗法纳入 ESCC 治疗模式代表了一个重大转变，改善了生存结果。未来的研究应侧重于优化联合治疗和新型免疫治疗药物，结合遗传和肿瘤微环境分析，以增强患者选择和治疗效果。
