Efficacy and safety of neoadjuvant chemotherapy with immunotherapy versus chemotherapy alone in esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials - Summary - MDSpire

Efficacy and safety of neoadjuvant chemotherapy with immunotherapy versus chemotherapy alone in esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials

  • By

  • Yibang Ye

  • Liangyu Zhang

  • Zhenyuan Yang

  • Yizhou Huang

  • Maohui Chen

  • Shuliang Zhang

  • Taidui Zeng

  • Chun Chen

  • Bin Zheng

  • July 9, 2026

  • 0 min

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Objective:

To systematically compare the efficacy and safety of neoadjuvant chemoimmunotherapy (NIC) versus neoadjuvant chemotherapy (NC) in resectable esophageal squamous cell carcinoma (ESCC) based on randomized controlled trials.

Approach:
  • Data Review: Systematic review of data from randomized controlled trials comparing NIC and NC in the treatment of resectable ESCC.
Key Findings:
  • Sixhigh-qualityRCTs(1070patients)wereincluded.NICsignificantlyimprovedmajorpathologicalresponse(MPR)(42.8%vs.22.2%,OR=2.40,p=0.0007)andpathologicalcompleteresponse(pCR)(22.2%vs.8.0%,OR=3.53,p<0.00001).NICshowedborderlinestatisticallysignificantimprovementsinoverallsurvival(OS)(HR=0.57,p=0.05)andR0resectionrate(OR=2.56,p=0.05).NICenhancedsurgicalrate(OR=1.57,p=0.02)andlymphnoderesection(MD=1.76,P=0.008).Higherincidenceofimmune-relatedadverseevents(iRAEs)inNIC(23.21%vs.1.16%,p<0.00001).
Interpretation:

NIC significantly improves pathological response and other perioperative benefits in resectable ESCC compared with NC, despite a higher incidence of immune-related adverse events.

Limitations:
  • Considerableheterogeneityinpooledestimates,particularlyregardingtheintervaltosurgery,whichmayaffectthereliabilityofthefindings.
Conclusion:

Further studies are needed to optimize treatment protocols and clarify the long-term impact of immune-related toxicities.

Original Source(s)

Efficacy and safety of neoadjuvant chemotherapy with immunotherapy versus chemotherapy alone in esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials

  • by Yibang Ye, Liangyu Zhang, Zhenyuan Yang, Yizhou Huang, Maohui Chen, Shuliang Zhang, Taidui Zeng, Chun Chen, Bin Zheng

  • July 9, 2026

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