Multicenter phase 3 trial of neoadjuvant chemotherapy with or without camrelizumab in resectable esophageal squamous cell carcinoma

The multicenter phase 3 ESCORT-NEO/NCCES01 trial in China evaluated addition of camrelizumab (anti-PD-1) to neoadjuvant chemotherapy for resectable locally advanced esophageal squamous cell carcinoma (LA-ESCC). Patients were randomized 1:1:1 to two cycles of camrelizumab plus nab-paclitaxel plus cisplatin (cam+nab-TP), camrelizumab plus paclitaxel plus cisplatin (cam+TP) or paclitaxel plus cisplatin (TP) followed by surgery and adjuvant camrelizumab in the two cam-groups. pCR rates were 28.0% in the cam+nab-TP group and 15.4% in the cam+TP group, significantly higher than the 4.7% in the TP group (p<0.0001 and p=0.0034, respectively). Event-free survival data are not yet mature. The incidence of grade 3 or higher treatment related adverse events during neoadjuvant treatment was 34.1% in the cam+nab-TP group, 29.2% in the cam+TP group, and 28.8% in the TP group; postoperative complication rates were 34.2%, 38.8%, and 32.0%, respectively. The authors conclude that addition of camrelizumab to neoadjuvant chemotherapy for LA-ESCC was associated with improved pCR rate, with a tolerable safety profile.