Evidence map›Paper›PMID 41776515›Full record

Trial reportBMC medicine2026

Neoadjuvant camrelizumab combined with metronomic chemotherapy in patients with advanced esophageal squamous cell carcinoma: a pilot randomized phase 2 trial.

Zhiming Chen, Wenshuai Li, Yumeng Guo, Yongjun Zhu, Yang Song, Jiayan Wu, Wanwei Zheng, Yujen Tseng, Lishuang Lin, Feng Tang and 17 more

Abstract readClinical Trial, Phase IIRandomized Controlled Trial
In one paragraph

Trial report in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Zhiming Chen *Department of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Wenshuai Li *Department of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Yumeng Guo *Department of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Yongjun Zhu *Department of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Yang Song *Department of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Jiayan Wu *Genecast Biotechnology Co., Ltd, Wuxi, Jiangsu, China.
Wanwei ZhengDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Yujen TsengDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Lishuang LinDepartment of Pathology, Huashan Hospital, Fudan University, Shanghai, China.
Feng TangDepartment of Pathology, Huashan Hospital, Fudan University, Shanghai, China.
Beibei MaoGenecast Biotechnology Co., Ltd, Wuxi, Jiangsu, China.
Peng ZhaoGenecast Biotechnology Co., Ltd, Wuxi, Jiangsu, China.
Xiangyu GuoDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Shiman FuDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Gang ChenDepartment of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Ning WuDepartment of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Bin LvDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Yao LiuDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Shenyang ZhaoDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Shaocong MoDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Kewei MaDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Kaiyi FuDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Hongyang ZhangDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Jun ZhangDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
Feifei LuoDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China. feifeiluo@fudan.edu.cn.
Zhongguang LuoDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China. luozg@fudan.edu.cn.
Jie LiuDepartment of Digestive Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China. jieliu@fudan.edu.cn.

Funding

National Natural Science Foundation of China 82121002.
6 · The paper itself

Abstract

backgroundCompared to conventional chemotherapy, metronomic chemotherapy (MCT), with lower drug dosage which may cause less damage to the immune system, has shown potential for synergy in combination with PD-1-based immunotherapy. However, this synergistic immunotherapy efficacy in neoadjuvant setting for advanced esophageal squamous cell carcinoma (ESCC) requires further clinical validation.

methodsThis pilot phase 2, single-center, randomized clinical trial enrolled 30 untreated patients with resectable stage II or III ESCC. Participants were randomly assigned to either the MCT group (paclitaxel, cisplatin, and 5-fluorouracil) or the IO + MCT group (same regimen plus camrelizumab). Primary outcomes included the pCR rate after neoadjuvant therapy, and the safety of each regimen assessed by adverse events. Digital spatial profiling (DSP-WTA), multiplex immunofluorescent staining (mIF), and bulk RNA sequencing were performed to explore the possible therapeutic mechanisms.

resultsTwenty-four patients (13 in MCT, 11 in IO + MCT) underwent R0 resection. The pCR rates were 15.4% in the MCT group and 54.5% in the IO + MCT group. Both treatments were well tolerated, with manageable side effects. DSP-WTA and mIF revealed that IO + MCT effectively decreased the number of tumor-infiltrating T cells with the positive expression of terminal exhaustion marker CD39 and increased the number of primary and secondary follicle-like tertiary lymphoid structures (TLSs), particularly in pCR patients.

conclusionsNeoadjuvant MCT combined with camrelizumab led to an increased pCR rate (54.5 vs. 16.7%) in ESCC patients compared to MCT alone. This combination therapy may offer a promising approach for enhancing cancer treatment outcomes.

trial registrationClinicalTrials.gov identifier: ChiCTR2000039638.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsEsophageal NeoplasmsEsophageal Squamous Cell CarcinomaNeoadjuvant TherapyAdministration, MetronomicAgedCisplatinFemaleFluorouracilHumansMaleMiddle AgedPaclitaxelPilot ProjectsAntibodies, Monoclonal, HumanizedcamrelizumabCisplatinFluorouracilPaclitaxelCamrelizumabEsophageal squamous cell carcinoma (ESCC)Metronomic chemotherapyNeoadjuvant therapy

Identifiers

PMID41776515
PMCPMC13063907

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.