Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis
Abstract Objective The objective of this study was to evaluate the clinical efficacy and safety of neoadjuvant immunochemotherapy in the treatment of locally advanced, resectable esophageal cancer. Methods Literature published before November 2023 on the clinical efficacy and safety of neoadjuvant i...
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BMC
2025-01-01
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| Series: | Systematic Reviews |
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| Online Access: | https://doi.org/10.1186/s13643-025-02765-8 |
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| author | Mingxing Wang Wanhui Dong Gongyi Wu Baorui Zhang Tong Lai Aixin Liu Qingming Sun |
| author_facet | Mingxing Wang Wanhui Dong Gongyi Wu Baorui Zhang Tong Lai Aixin Liu Qingming Sun |
| author_sort | Mingxing Wang |
| collection | DOAJ |
| description | Abstract Objective The objective of this study was to evaluate the clinical efficacy and safety of neoadjuvant immunochemotherapy in the treatment of locally advanced, resectable esophageal cancer. Methods Literature published before November 2023 on the clinical efficacy and safety of neoadjuvant immunotherapy in resectable esophageal squamous cell carcinoma was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature, PubMed, Embase, Cochrane, and the Web of Science. A meta-analysis was conducted using Stata 17.0. Results The cumulative ranked probability results indicated that Camrelizumab + TN had the highest probability of achieving pCR, Camrelizumab + TP of achieving MPR, and Sintilimab + TP of achieving DCR and ORR. Camrelizumab + TP also had the highest probability of achieving an R0 resection rate. In terms of adverse events and postoperative complications, Pembrolizumab + TN had the highest likelihood of inducing myelosuppression and rash. Toripalimab + TP had the highest probability of inducing vomiting, while traditional chemotherapy alone had the highest likelihood of inducing postoperative cardiac adverse events. Conclusion Neoadjuvant immunotherapy combined with chemotherapy has demonstrated superior clinical efficacy and safety compared to chemotherapy alone. The regimen of Camrelizumab + TP showed significant advantages in pCR, MPR, DCR, and R0 resection rates, particularly excelling in MPR and R0 resection rates. However, it was associated with a higher incidence of rash compared to chemotherapy alone and the Toripalimab + TP regimen. Neoadjuvant immunotherapy, when combined with chemotherapy, has been shown to reduce the occurrence of postoperative cardiac adverse events. Among the various treatment options, Sintilimab + TP exhibited the most favorable outcomes. Systematic review registration PROSPERO Protocol Number: CRD42024623160. |
| format | Article |
| id | doaj-art-0b20bba67aad44a5b1c614dc7166a12a |
| institution | Kabale University |
| issn | 2046-4053 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj-art-0b20bba67aad44a5b1c614dc7166a12a2025-02-02T12:11:01ZengBMCSystematic Reviews2046-40532025-01-0114111210.1186/s13643-025-02765-8Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysisMingxing Wang0Wanhui Dong1Gongyi Wu2Baorui Zhang3Tong Lai4Aixin Liu5Qingming Sun6Department of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineDepartment of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineDepartment of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineDepartment of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineDepartment of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineDepartment of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineDepartment of Medical Oncology, Lu’an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese MedicineAbstract Objective The objective of this study was to evaluate the clinical efficacy and safety of neoadjuvant immunochemotherapy in the treatment of locally advanced, resectable esophageal cancer. Methods Literature published before November 2023 on the clinical efficacy and safety of neoadjuvant immunotherapy in resectable esophageal squamous cell carcinoma was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature, PubMed, Embase, Cochrane, and the Web of Science. A meta-analysis was conducted using Stata 17.0. Results The cumulative ranked probability results indicated that Camrelizumab + TN had the highest probability of achieving pCR, Camrelizumab + TP of achieving MPR, and Sintilimab + TP of achieving DCR and ORR. Camrelizumab + TP also had the highest probability of achieving an R0 resection rate. In terms of adverse events and postoperative complications, Pembrolizumab + TN had the highest likelihood of inducing myelosuppression and rash. Toripalimab + TP had the highest probability of inducing vomiting, while traditional chemotherapy alone had the highest likelihood of inducing postoperative cardiac adverse events. Conclusion Neoadjuvant immunotherapy combined with chemotherapy has demonstrated superior clinical efficacy and safety compared to chemotherapy alone. The regimen of Camrelizumab + TP showed significant advantages in pCR, MPR, DCR, and R0 resection rates, particularly excelling in MPR and R0 resection rates. However, it was associated with a higher incidence of rash compared to chemotherapy alone and the Toripalimab + TP regimen. Neoadjuvant immunotherapy, when combined with chemotherapy, has been shown to reduce the occurrence of postoperative cardiac adverse events. Among the various treatment options, Sintilimab + TP exhibited the most favorable outcomes. Systematic review registration PROSPERO Protocol Number: CRD42024623160.https://doi.org/10.1186/s13643-025-02765-8Esophageal cancerNeoadjuvantImmunotherapy |
| spellingShingle | Mingxing Wang Wanhui Dong Gongyi Wu Baorui Zhang Tong Lai Aixin Liu Qingming Sun Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis Systematic Reviews Esophageal cancer Neoadjuvant Immunotherapy |
| title | Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis |
| title_full | Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis |
| title_fullStr | Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis |
| title_full_unstemmed | Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis |
| title_short | Efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage II–IVa esophageal cancer: a network meta-analysis |
| title_sort | efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for stage ii iva esophageal cancer a network meta analysis |
| topic | Esophageal cancer Neoadjuvant Immunotherapy |
| url | https://doi.org/10.1186/s13643-025-02765-8 |
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