Adjuvant Immunotherapy in Curative Intent Esophageal Cancer Resection Patients: Real-World Experience within an Integrated Health System.

Autor: Kwak HV; Department of Surgery, University of California, San Francisco-East Bay, 1411 E 31st Street, QIC 22134, Oakland, CA 94602, USA., Banks KC; Department of Surgery, University of California, San Francisco-East Bay, 1411 E 31st Street, QIC 22134, Oakland, CA 94602, USA., Hung YY; Biostatistical Consulting Unit, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA., Alcasid NJ; Department of Surgery, University of California, San Francisco-East Bay, 1411 E 31st Street, QIC 22134, Oakland, CA 94602, USA., Susai CJ; Department of Surgery, University of California, San Francisco-East Bay, 1411 E 31st Street, QIC 22134, Oakland, CA 94602, USA., Patel A; Division of Thoracic Surgery, Department of Surgery, Kaiser Permanente Northern California, 3600 Broadway, Oakland, CA 94612, USA., Ashiku S; Division of Thoracic Surgery, Department of Surgery, Kaiser Permanente Northern California, 3600 Broadway, Oakland, CA 94612, USA., Velotta JB; Division of Thoracic Surgery, Department of Surgery, Kaiser Permanente Northern California, 3600 Broadway, Oakland, CA 94612, USA.; Department of Surgery, University of California, San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143, USA.; Department of Clinical Medicine, Kaiser Permanente Bernard J. Tyson School of Medicine, 98 S Los Robles Ave, Pasadena, CA 91101, USA.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Nov 07; Vol. 15 (22). Date of Electronic Publication: 2023 Nov 07.
DOI: 10.3390/cancers15225317
Abstrakt: Background: Adjuvant immunotherapy has been shown in clinical trials to prolong the survival of patients with esophageal cancer. We report our initial experience with immunotherapy within an integrated health system.
Methods: A retrospective cohort study was performed reviewing patients undergoing minimally invasive esophagectomy at our institution between 2017 and 2021. The immunotherapy cohort was assessed for completion of treatment, adverse effects, and disease progression, with emphasis on patients who received surgery in 2021 and their eligibility to receive nivolumab.
Results: There were 39 patients who received immunotherapy and 137 patients who did not. In logistic regression, immunotherapy was not found to have a statistically significant impact on 1-year overall survival after adjusting for age and receipt of adjuvant chemoradiation. Only seven patients out of 39 who received immunotherapy successfully completed treatment (18%), with the majority failing therapy due to disease progression or side effects. Of the 17 patients eligible for nivolumab, 13 patients received it (76.4%), and three patients completed a full course of treatment.
Conclusions: Despite promising findings of adjuvant immunotherapy improving the survival of patients with esophageal cancer, real-life practice varies greatly from clinical trials. We found that the majority of patients were unable to complete immunotherapy regimens with no improvement in overall 1-year survival.
Databáze: MEDLINE
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