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ORIGINAL ARTICLE
Year : 2022  |  Volume : 18  |  Issue : 2  |  Page : 545-552

PD-1 inhibitor monotherapy versus combination therapy: A real-world study of patients with recurrent or metastatic advanced esophageal squamous cell carcinoma after first-line chemotherapy


1 Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University; Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
2 Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
3 Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
4 Department of Radiation Oncology, the Zhangqiu District People's Hospital of Jinan, Shandong, China

Correspondence Address:
Baosheng Li
Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012; and Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan - 250002
China
Wei Huang
Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong - 250012
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrt.jcrt_125_22

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Context: Although programmed death 1 (PD-1) inhibitors are a standard second-line treatment for esophageal squamous cell carcinoma (ESCC), their efficacy when used in combination with chemotherapy or anti-angiogenesis targeted therapy is unclear. Aim: To compare the efficacy and safety of PD-1 inhibitor monotherapy with that of combination therapy. Setting and Design: A retrospective study was conducted at the Shandong Cancer Hospital. Materials and Methods: Based on records, patients with advanced ESCC, treated with second-line or above PD-1 inhibitor-containing regimens from August 15, 2019 to April 12, 2021 were divided into combination (PD-1 inhibitors plus chemotherapy or anti-angiogenesis targeted therapy) and monotherapy groups. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical Analysis Used: The baseline differences between subgroups were assessed using the χ2-test, Fisher's exact test, or Student's t-test. Follow-up period, PFS, OS, median survival, and 95% confidence intervals (CIs) were estimated using Kaplan‒Meier analysis. The log-rank test was used to compare subgroups. Results: In the 169 patients included, clinical features were well balanced between both groups. The median PFS of the combination group was better than that of the monotherapy group (8.5 months [95%CI 6.3–10.7] vs. 3.2 months [95%CI 0.0–6.5]; hazard ratio (HR) = 0.34 [95%CI 0.13–0.92]; P < 0.001). The median OS showed the same trend (18.9 months [95%CI 14.4–23.3] vs. 9.8 months [95%CI 6.3–13.2]; HR = 0.47 [95%CI 0.21–1.04]; P = 0.010). Conclusion: Using PD-1 inhibitors in a combination treatment may improve PFS and OS, with acceptable toxicities.


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