Adjuvant Therapy After Neoadjuvant Immunochemotherapy Improves Survival in Resected ESCC

This multicenter real-world analysis helps pharmacists weigh whether adding immunotherapy to adjuvant chemotherapy adds value after neoadjuvant immunochemotherapy in resected esophageal squamous cell carcinoma.

esophageal squamous cell carcinomaneoadjuvant immunochemotherapyadjuvant chemotherapyadjuvant chemoimmunotherapyimmune checkpoint inhibitorstislelizumabpembrolizumabsintilimabcamrelizumabtoripalimabreal-world studypropensity score matchingoverall survivaldisease-free survival Oncology Pharmacy

Background Information

Postoperative adjuvant therapy enhances survival for ESCC after neoadjuvant treatment.

Identifying the best postoperative adjuvant therapy for esophageal squamous cell carcinoma (ESCC) after neoadjuvant immunochemotherapy (nICT) is crucial for improving patient outcomes. Postoperative adjuvant chemotherapy (POCT) and chemoimmunotherapy (POICT) both improved overall survival (OS) and disease-free survival (DFS) compared to observation. In non-pathological complete response (non-pCR) patients, both methods were effective, but only POICT helped pathological complete response (pCR) patients. This study highlights that while adding immunotherapy to chemotherapy (POICT) does not significantly extend survival in all matched patients, it may benefit pCR patients specifically. For ESCC patients post-nICT, adjuvant therapy improves survival; POICT may benefit pCR patients more.

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Authors: Zhang X, Gao H, Cao J, Gao M, Xu Y, Zhang W, Qian P, Liu X, Fu Z, Shen W

Citation: Zhang X, Gao H, Cao J, et al. A real-world multicenter study on postoperative adjuvant treatment patterns and prognostic implications following neoadjuvant immunochemotherapy for esophageal squamous cell carcinoma. Frontiers in immunology. 2026;17:1811836. doi:10.3389/fimmu.2026.1811836

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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