Multicenter phase 2 trial of induction sintilimab plus chemotherapy followed by concurrent chemoradiotherapy for locally advanced ESCC

Concurrent chemoradiotherapy (CRT) is the standard nonoperative treatment for locally advanced esophageal squamous cell carcinoma (LA ESCC). Local recurrence is the main failure pattern, indicating that the sensitivity for radiotherapy needs to be improved. A multicenter phase 2 trial in China evaluated induction sintilimab plus paclitaxel and carboplatin followed by CRT. The 2-year local control rate was 81.7% (95% CI 72.7-90.7), which was much higher than what was seen in previous studies with CRT only (71.3%). Vascular normalization and hypoxia alleviation were observed after the induction phase. Median progression-free and overall survival were not reached during median 33.6 months of follow-up (IQR29.3-35.7). The authors conclude that the addition of induction immunotherapy to standard CRT could improve radiosensitivity of LA ESCC. Induction immunotherapy followed by concurrent CRT could be a new nonoperative option for patients with LA ESCC.