Sequential versus concurrent neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma: a randomized, controlled, open-label, phase 2 trial (HCHTOG1906)

Category	Detail
Condition	Locally Advanced Esophageal Squamous Cell Carcinoma (ESCC)
Key Mechanisms	Combination of chemotherapy and PD-1 inhibitors to enhance anti-tumor response through immunogenic cell death and modulation of the tumor immune microenvironment.
Target Population	Patients aged 18-70 with resectable locally advanced ESCC, ECOG performance status 0-1.
Care Setting	Phase II randomized controlled trial conducted in a clinical setting.

Overall pathological complete remission (pCR) rate was 22.2% with no significant difference between sequential (17.8%) and concurrent (26.9%) groups.
Concurrent group had higher rates of nausea and diarrhea.
No significant differences in overall survival (OS) or disease-free survival (DFS) between treatment groups.
14.2% of patients experienced grade 3-5 treatment-related adverse events (TRAEs).
6 treatment-related fatalities occurred, predominantly in the concurrent group.

Neoadjuvant therapy with either sequential or concurrent administration of chemotherapy and PD-1 inhibitors.

Increased risk of nausea, diarrhea, and treatment-related fatalities in the concurrent group.

Adults aged 18-70 with resectable locally advanced ESCC.

Sequential administration may enhance safety profile compared to concurrent administration.

Consider patient-specific factors when choosing between sequential and concurrent neoadjuvant therapy.
Monitor for treatment-related adverse events closely, especially in the concurrent group.

Clinical Scorecard: Comparative Analysis of Sequential and Concurrent Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma: Results from a Phase 2 Randomized Controlled Trial (HCHTOG1906)