SynthesisBMC gastroenterology2025
Neoadjuvant chemotherapy with or without PD-1/PD-L1 inhibitors in resectable esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials.
Synthesis in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of neoadjuvant chemotherapy with immunotherapy versus chemotherapy alone in esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials.Frontiers in immunology · 2026Pooled it
- A Prospective Multicenter Comparative Cohort Study of Neoadjuvant Sintilimab Plus Chemotherapy and Chemoradiotherapy in Resectable Clinical Node-Positive Esophageal Squamous Cell Carcinoma.Annals of surgical oncology · 2026Observational
- Evaluation of the abscopal-like effect of radioimmunotherapy on sentinel lymph nodes in H22 hepatocellular carcinoma via dynamic lymphography.BMC cancer · 2026Article
- Lesion-level comparison of primary and secondary tumors after neoadjuvant immunochemotherapy in multifocal esophageal squamous cell carcinoma: a single-center retrospective study.Journal of thoracic disease · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundNeoadjuvant chemotherapy (NC) is a cornerstone in the management of resectable esophageal squamous cell carcinoma (ESCC). The integration of PD-1/PD-L1 inhibitors into NC (NIC) regimens has shown promise; however, its efficacy and safety remain uncertain. This meta-analysis aims to compare the potential risks and clinical benefits of NIC versus NC in patients with resectable ESCC based on randomized controlled trials (RCTs).
methodsA thorough search of six databases was performed to identify RCTs evaluating NIC and NC in resectable ESCC. Key outcomes analyzed included the pathological complete response (pCR) rate and the major pathological response (MPR) rate. Other outcomes analyzed included overall survival (OS), event-free survival (EFS), surgery rate, R0 resection rate, and adverse events (AEs).
resultsFour RCTs encompassing 605 patients were included. NIC significantly improved pCR rate (risk ratio [RR]: 2.66 [1.63, 4.34], P < 0.0001) and MPR rate (RR: 1.74 [1.02, 2.95], P = 0.04) compared to the NC group. Only one phase III RCT reported survival outcomes, showing that the NIC group demonstrated improved OS (HR: 0.48 [0.24, 0.96], P = 0.04) and EFS (HR: 0.62 [0.39, 0.99], P = 0.05). Additionally, surgery rate (RR: 1.11 [1.03, 1.20], P = 0.008) and the number of resected lymph nodes (mean difference [MD]: 3.91 [0.60, 7.21], P = 0.02) were also higher in the NIC group. The R0 resection rate, duration of surgery, and intraoperative blood loss were comparable between the groups. However, the rate of immune-related AEs (irAEs) (RR: 40.80 [5.67, 293.37], P = 0.0002) was significantly higher in the NIC group. Similar surgical complications were observed between the two groups.
conclusionsNIC demonstrates superior efficacy in improving pCR and MPR in resectable ESCC compared to NC alone, and may potentially provide survival benefits, although it is associated with a higher risk of irAEs.
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