Adding PD-1 inhibition to chemoradiotherapy for oesophageal cancer
Mené en Chine entre 2019 et 2021 sur 42 patients atteints d'un carcinome épidermoïde de l'oesophage de stade I-IVA non résécable (durée médiane de suivi : 14,9 mois ; âge médian : 56 ans ; 76 % d'hommes), cet essai de phase II évalue l'efficacité, du point de vue de la réponse complète à 3 mois, d'un traitement associant toripalimab et chimioradiothérapie définitive
In clinical practice, advances in immunotherapy have not yet reached patients with unresectable oesophageal squamous cell carcinoma treated with definitive chemoradiotherapy. The results of the single-arm, phase 2 EC-CRT-001 trial reported in The Lancet Oncology by Mian Xi and colleagues 1 contribute to this field by investigating the addition of toripalimab, a PD-1 inhibitor, to definitive chemoradiotherapy. The primary endpoint, complete response after 3 months (based on endoscopy with biopsy and PET imaging), was met in 26 (62%; 95% CI 46–76) of 42 patients, which, in a post-hoc analysis, was significantly higher than the complete response rate of a propensity score-matched historical cohort (35 [42%] of 84 patients). Although comparison with a propensity score-matched cohort does not match the scientific rigour of a randomised study design, by reducing confounding and bias, propensity score matching can support the estimate of causal treatment effects for an observational study.
The Lancet Oncology 2022