Toripalimab plus chemotherapy for advanced esophageal squamous cell carcinoma: final overall survival analysis of JUPITER-06

The multicenter phase 3 JUPITER-06 trial in China evaluated toripalimab plus chemotherapy for advanced esophageal squamous cell carcinoma (aESCC). Final overall survival (OS) analysis of the trial has now been published. A total of 514 patients with previously untreated aESCC were randomized 1:1 to toripalimab or placebo in combination with paclitaxel plus cisplatin (TP) every 3 weeks for up to 6 cycles, followed by toripalimab or placebo maintenance. Toripalimab plus TP significantly improved OS versus placebo plus TP (17.7 versus 12.9 months; HR 0.72; p=0.002), with 3-year OS rates 29.7% versus 19.9%. Neither PD-L1 expression nor tumor mutation burden (TMB) significant correlated with OS benefit, but copy number alteration-corrected TMB (ccTMB) and esophageal cancer genome-based immuno-oncology classification (EGIC) scheme robustly stratified patients with different long-term OS benefits from immunochemotherapy. The authors conclude that this final OS analysis of JUPITER-06 confirms the sustained survival benefit of toripalimab plus chemotherapy in aESCC, with precise patients stratification by ccTMB and EGIC.