Key Laboratory of Clinical Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Sci Rep. 2024 Jul 31;14(1):17708. doi: 10.1038/s41598-024-68820-x.
Neoadjuvant therapy (NAT) is an important treatment for patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC), but neoadjuvant resistance affects the overall treatment outcome. Therefore, it is particularly important to accurately screen the population for NAT and explore the mechanism of resistance. Usually, different chemotherapy regimens cause different drug resistance mechanisms. Prior to combining immunotherapy with chemotherapy, extensive research has been conducted on previous drug resistance mechanisms. Currently, the mainstream NAT for ESCC involves chemotherapy combined with immunotherapy. We have witnessed the remarkable effect of this combination therapy; however, there are still a considerable number of patients whose tumor tissues show no change or even progress after NAT, and their drug resistance mechanisms remain unclear. Hence, we aim to identify relevant evidence that can distinguish and predict the effectiveness of NAT from a clinical perspective in order to provide a clinical basis for future screening of suitable populations for NAT and discovery of drug resistance mechanisms. This study is based in China's high incidence area of esophageal cancer, where enrolled patients all receive the current mainstream NAT regimen resulting in more reliable outcomes.
新辅助治疗（NAT）是可切除局部晚期食管鳞癌（ESCC）患者的重要治疗方法，但新辅助耐药影响整体治疗效果。因此，准确筛选 NAT 人群并探索耐药机制尤为重要。通常，不同的化疗方案会导致不同的耐药机制。在将免疫疗法与化疗联合使用之前，已经对先前的耐药机制进行了广泛的研究。目前，ESCC 的主流 NAT 涉及化疗联合免疫疗法。我们已经看到了这种联合治疗的显著效果；然而，仍有相当数量的患者在 NAT 后其肿瘤组织没有变化甚至进展，其耐药机制尚不清楚。因此，我们旨在从临床角度确定相关证据，以区分和预测 NAT 的有效性，从而为未来筛选适合 NAT 的人群和发现耐药机制提供临床依据。这项研究基于中国食管癌高发地区，入组患者均接受当前主流的 NAT 方案，结果更可靠。
