Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series
Neoadjuvant chemoimmunotherapy (NCIT) has improved pathological complete response and conferred survival benefits in patients with locally advanced esophageal cancer. However, surgical complications unrelated to the tumor continue to detract from patient outcomes. While the “watch-and-wait” strategy...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1502206/full |
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| author | Lingyu Tan Lingyu Tan Guozhen Yang Guozhen Yang Chufeng Zeng Chufeng Zeng Xu Zhang Xu Zhang Xu Zhang |
| author_facet | Lingyu Tan Lingyu Tan Guozhen Yang Guozhen Yang Chufeng Zeng Chufeng Zeng Xu Zhang Xu Zhang Xu Zhang |
| author_sort | Lingyu Tan |
| collection | DOAJ |
| description | Neoadjuvant chemoimmunotherapy (NCIT) has improved pathological complete response and conferred survival benefits in patients with locally advanced esophageal cancer. However, surgical complications unrelated to the tumor continue to detract from patient outcomes. While the “watch-and-wait” strategy has been implemented in clinical complete responders following neoadjuvant therapy for rectal cancer, there is a lack of evidence supporting its practicability in esophageal cancer after NCIT. This pilot case series involves six clinical complete responders who deferred surgery under close surveillance after three or four cycles of neoadjuvant camrelizumab plus chemotherapy and who subsequently received camrelizumab as maintenance treatment. The primary observation measure of the series is event-free survival (EFS). Routine follow-up examinations included endoscopy, biopsy, contrast-enhanced computed tomography, and ultrasonography every 3–6 months. For patients who experienced local recurrence without metastasis, the salvage operation was the priority recommendation. As of September 5, 2024, the average follow-up duration was 124.4 weeks, with the average EFS reaching 134.7 weeks. No deaths or distant metastases were observed. Our findings suggest that responders to NCIT may be spared from esophagectomy. On the prerequisite of sufficient tumor regression during neoadjuvant cycles, immunotherapy may facilitate the continued eradication of residual disease in this series. |
| format | Article |
| id | doaj-art-eb15a4f7a7df4c4bba7396db7bb49ad6 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-eb15a4f7a7df4c4bba7396db7bb49ad62025-01-06T06:59:42ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.15022061502206Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case seriesLingyu Tan0Lingyu Tan1Guozhen Yang2Guozhen Yang3Chufeng Zeng4Chufeng Zeng5Xu Zhang6Xu Zhang7Xu Zhang8Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaGuangdong Esophageal Cancer Institute, Guangzhou, ChinaNeoadjuvant chemoimmunotherapy (NCIT) has improved pathological complete response and conferred survival benefits in patients with locally advanced esophageal cancer. However, surgical complications unrelated to the tumor continue to detract from patient outcomes. While the “watch-and-wait” strategy has been implemented in clinical complete responders following neoadjuvant therapy for rectal cancer, there is a lack of evidence supporting its practicability in esophageal cancer after NCIT. This pilot case series involves six clinical complete responders who deferred surgery under close surveillance after three or four cycles of neoadjuvant camrelizumab plus chemotherapy and who subsequently received camrelizumab as maintenance treatment. The primary observation measure of the series is event-free survival (EFS). Routine follow-up examinations included endoscopy, biopsy, contrast-enhanced computed tomography, and ultrasonography every 3–6 months. For patients who experienced local recurrence without metastasis, the salvage operation was the priority recommendation. As of September 5, 2024, the average follow-up duration was 124.4 weeks, with the average EFS reaching 134.7 weeks. No deaths or distant metastases were observed. Our findings suggest that responders to NCIT may be spared from esophagectomy. On the prerequisite of sufficient tumor regression during neoadjuvant cycles, immunotherapy may facilitate the continued eradication of residual disease in this series.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1502206/fullneoadjuvant chemoimmunotherapywatch and waitesophageal cancerclinical complete responsePD-1 blockade |
| spellingShingle | Lingyu Tan Lingyu Tan Guozhen Yang Guozhen Yang Chufeng Zeng Chufeng Zeng Xu Zhang Xu Zhang Xu Zhang Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series Frontiers in Immunology neoadjuvant chemoimmunotherapy watch and wait esophageal cancer clinical complete response PD-1 blockade |
| title | Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series |
| title_full | Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series |
| title_fullStr | Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series |
| title_full_unstemmed | Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series |
| title_short | Case report: Watch-and-wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy: a case series |
| title_sort | case report watch and wait strategy in resectable esophageal cancer following neoadjuvant chemoimmunotherapy a case series |
| topic | neoadjuvant chemoimmunotherapy watch and wait esophageal cancer clinical complete response PD-1 blockade |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1502206/full |
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