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- Title
Durvalumab and tremelimumab with definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma.
- Authors
Park, Sehhoon; Oh, Dongryul; Choi, Yoon‐La; Chi, Sang Ah; Kim, Kyunga; Ahn, Myung‐Ju; Sun, Jong‐Mu
- Abstract
Background: The current standard treatment for patients with inoperable, locally advanced esophageal squamous cell carcinoma (ESCC) is definitive concurrent chemoradiotherapy (CCRT). Methods: Patients with locally advanced ESCC received 2 cycles of 5‐fluorouracil, cisplatin, durvalumab, and tremelimumab every 3 weeks with concurrent radiation therapy (60.2 or 64.5 grays). After completing CCRT plus immunotherapy, patients received 2 cycles of consolidative durvalumab and tremelimumab followed by durvalumab monotherapy every 4 weeks for 2 years after enrollment. Their survival outcomes were compared with those from a propensity score‐matched historical control group that had received CCRT alone. Results: In total, 40 patients were enrolled and analyzed. The 24‐month progression‐free survival (PFS) and overall survival rates were 57.5% and 75%, respectively. Compared with the historical control group (n = 75), the study population had significantly longer PFS (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.28‐0.97; P =.040) and overall survival (HR, 0.49; 95% CI, 0.25‐0.98; P =.043). In the study population, patients who had PD‐L1–positive tumors (n = 28) had significantly longer PFS (HR, 0.20; 95% CI, 0.07‐0.54; P <.001) and overall survival (HR, 0.16; 95% CI, 0.05‐0.56; P =.001) compared with those who had PD‐L1–negative tumors (n = 11). However, there was no difference in survival outcomes according to PD‐L1 status in the historical control group, indicating a strong interaction between PD‐L1–positive status and survival outcomes in the treatment groups (PFS, P for interaction =.003; overall survival, P for interaction =.002). Conclusions: Durvalumab and tremelimumab with definitive CCRT had promising efficacy in patients with locally advanced ESCC. In addition, PD‐L1 expression had strong predictive value in the study population. The clinical efficacy of durvalumab and tremelimumab with definitive chemoradiotherapy was studied in patients who had inoperable esophageal squamous cell carcinoma. Significantly longer progression‐free and overall survival were observed compared with a propensity scored‐matched historical control group, and PD‐L1 expression seemed to have a strong predictive role in patients who had positive PD‐L1 combined proportion scores.
- Publication
Cancer (0008543X), 2022, Vol 128, Issue 11, p2148
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.34176