Keynote 590 trial9/28/2023 ![]() ![]() Immune checkpoint inhibitors have shown significant survival benefits for patients with advanced esophageal cancer in several clinical trials. ![]() However, the overall survival of this population remains poor with an estimated median of 12 months. Combination fluoropyrimidine plus platinum-based chemotherapy and single-agent chemotherapy are recommended as the first-line and second-line treatments for patients with advanced or metastatic esophageal cancer, respectively. Many esophageal cancers are advanced or metastatic at diagnosis. PROSPERO registration number: (CRD 42021261554).Įsophageal cancer is the seventh most common cancer and ranks sixth for cancer-related mortality worldwide, with squamous-cell carcinoma (ESCC) accounting for approximately 85% of cases. The toxicity of immunotherapy was different from conventional chemotherapy, but manageable in patients with ESCC. Sintilimab and Camrelizumab were the preferred options for OS and PFS in refractory patients respectively. This study found that Toripalimab and Camrelizumab plus chemotherapy were likely to be the best option in terms of OS and PFS in the first-line setting for patients with advanced or metastatic ESCC respectively. Camrelizumab and Nivolumab had the less adverse events of grade 3 or higher in the first and refractory setting, respectively. The toxicity related to immunotherapy was manageable in clinical trials. In refractory patients, Sintilimab and Camrlizumab were most likely to be ranked first on OS (probability, 37%) and PFS (probability, 94%). Toripalimab and Camrelizumab plus chemotherapy were preferred to rank first on OS (probability, 61%) and PFS (probability, 37%) in the first-line setting, respectively. Ten eligible trials with 5250 patients were included. Outcomes included overall survival (OS), progression-free survival (PFS), overall response rate and adverse events. We conducted Bayesian network meta-analysis to assess the relative effects among treatments. We searched Medline, Web of Science, Cochrane Central Register of Controlled Trials, Embase, Clinical and several international conference databases from Januto December 19, 2021. The study aimed to compare efficacy and safety of various immune checkpoint inhibitors for patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC). ![]()
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