The efficacy and safety of programmed cell death protein 1 inhibitor combined with chemotherapy in elderly patients with advanced esophageal squamous cell carcinoma
Bie Zhixin
Guo Runqi
Li Bin
Wang Cheng'en
Xu Sheng
Li Yuanming
Li Xiaoguang
Li Lin
Abstract：Objective To investigate the efficacy and safety of programmed cell death protein 1(PD-1)inhibitor combined with chemotherapy in elderly patients with advanced esophageal squamous cell carcinoma.Methods This study was a retrospective cohort study.A total of 95 elderly patients with unresectable locally advanced or metastatic esophageal squamous cell carcinoma diagnosed and treated in Beijing Hospital from October 2019 to December 2022 were consecutively enrolled.The patients were divided into PD-1 inhibitor group(30 cases)and control group(65 cases)according to whether PD-1 inhibitors were used.Both groups were given paclitaxel and cisplatin chemotherapy,and PD-1 inhibitor group was also given PD-1 inhibitor.Paclitaxel and cisplatin chemotherapy and PD-1 inhibitor were given every 3 weeks.The patients were treated until disease progression or intolerance or death.The follow-up ended on December 31,2023.The overall survival,progression-free survival and objective response rate of the two groups were compared,and the important factors affecting overall survival were evaluated by multivariate Cox regression analysis.Results Patients in the PD-1 inhibitor group were relatively older than those in the control group,but the difference was not statistically significant(P＞0.05).During the follow-up period,65 patients died,including 16 cases(53.3％)in the PD-1 inhibitor group and 49 cases(75.4％)in the control group.The overall survival[15.1(12.4,18.9)months vs 11.3(9.2,15.7)months,P=0.002]and progression-free survival[6.6(5.0,7.4)months vs 5.0(3.8,6.6)months,P=0.004]of the PD-1 inhibitor group were longer than those of the control group,and the objective response rate was higher than that of the control group[56.7％(17/30)vs 40.0％(26/65),x2=4.196,P=0.041].There was no significant difference in the incidence of grade ≥3 adverse reactions between the PD-1 inhibitor group and the control group[56.7％(17/30)vs 50.8％(33/65),x2=0.793,P=0.261].Multivariate Cox regression analysis showed that body mass index,Eastern Cooperative Oncology Group score,distant metastasis at enrollment,programmed cell death ligand 1 combined positive score≥1 and PD-1 inhibitor treatment were important factors affecting overall survival(hazard ratio=0.893,0.779,1.730,0.693,0.772;all P＜0.05).Conclusion PD-1 inhibitor combined with chemotherapy has good efficacy and safety in elderly patients with advanced esophageal squamous cell carcinoma.
Keywords：Esophageal squamous cell carcinomaProgrammed cell death receptor 1 inhibitorChemotherapy
Publication Date：2024-12-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1796-1800 )