Nab-paclitaxel plus capecitabine en PD-1-remmer bij gemetastaseerd of lokaal gevorderd maagcarcinoom

BACKGROUND: Over half of esophageal cancer (EC) cases occur in China, where paclitaxel and platinum agents have become the preferred chemotherapeutic regimen for EC patients. However, there is a clinical need for a non-platinum-based therapeutic option. METHODS: Cases were collected from Sun Yat-sen University Cancer Center between January 2019 and November 2023. Patients with metastatic or locally advanced EC received 4-6 cycles of chemo-immunotherapy, including nab-paclitaxel, capecitabine, and a programmed death receptor 1 (PD-1) inhibitor, with or without subsequent surgery, radiotherapy, or maintenance therapy. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), pathological complete response (pCR), complete (R0) resection rate, and major pathologic response (MPR) were assessed. RESULTS: Among the 72 patients retrospectively analyzed, the median PFS was 24.7 months (95% confidence interval: 7.0-42.3 months). 75% of patients were regarded as responders, with an ORR of 66.7% in 42 patients with measurable lesions. The 6-month, 1-year, and 2-year PFS rates (DCRs) were 100%, 96.2%, and 67.9%, respectively. In total, 9 patients underwent surgery, and 29 patients received radiotherapy following the regimen. The R0 resection rate was 77.8%, while both pCR and MPR were 66.7%. The most common adverse events were myelosuppression (27.8%) and liver dysfunction (25.0%). CONCLUSION: Our study demonstrated that the combination of nab-paclitaxel, capecitabine, and a PD-1 inhibitor was an effective and tolerable strategy for EC patients and a promising first-line or neoadjuvant treatment option.