Current research status and challenges of neoadjuvant immunotherapy for Esophageal squamous cell carcinoma - PubMed
2 days ago
- #Neoadjuvant immunotherapy
- #Esophageal cancer
- #Tumor microenvironment
- Neoadjuvant immunotherapy (NIT) improves pathological complete response (pCR) rates in esophageal squamous cell carcinoma (ESCC).
- Combining PD-1 inhibitors (e.g., pembrolizumab, camrelizumab) with chemotherapy increases pCR rates to over 40% and 28%, respectively.
- NIT remodels the tumor microenvironment by expanding SPRY1+CD8+ T cells and promoting M1 macrophage polarization.
- Novel biomarkers like SPRY1+CD8+ T cell infiltration, EN-ImiRPS model, and ctDNA monitoring improve treatment response prediction.
- High PD-L1 expression patients may benefit from ICI monotherapy; ctDNA-negative cCR patients can explore non-surgical organ preservation.
- Adjuvant nivolumab extends disease-free survival for non-pCR patients post-surgery.
- Primary resistance challenges include M2 macrophage suppression and cancer stem cell escape.
- Future research should focus on multi-omics biomarkers, de-escalation strategies, and targeting resistant pathways.