Pembrolizumab as a first-line therapy in spinocellular esophageal cancer

Česká verzia

Authors: MUDr. Křížová Udmila ¹; doc. MUDr. Charvát František, Ph.D. ²; prof. MUDr. Petruželka Luboš, CSc. ¹
Authors place of work: Onkologická klinika 1. LF UK a VFN v Praze ¹; Radiodiagnostické oddělení, ÚVN Praha ²
Published in the journal: Klin Onkol 2021; 34(1): 59-61
Category: Case Report
doi: https://doi.org/10.48095/ccko202159

Summary

Background: The treatment options in advanced stage of esophageal cancer are very limited. In recent years, a number of clinical trials have evaluated the effect of checkpoint inhibitors in this diagnosis.

Case: In our case report, we will demonstrate the administration of pembrolizumab in first-line therapy in generalized squamous cell carcinoma of the esophagus with PD-L1 expression > 70%. Complete remission of the disease was achieved by this approach.

Conclusion: Our case report shows the importance of investigating the expression of PD-L1 in advanced esophageal cancer. According to previous findings, immunotherapy, unlike chemotherapy, appears to have the potential to elicit a long-term response.

Keywords:

immunotherapy – esophageal neoplasms – checkpoint inhibitors – clinical studies – PD-L1 – first-line treatment

Zdroje

1. National Comprehensive Cancer. Esophageal and esophagogastric junction cancers (version 4.2020). [online]. Available from: https: //www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf, 2020.

2. Lordick F, Mariette C, Haustermans K et al. Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27 (5): v50–57.

3. Fuchs CS, Doi T, Jang RW et al. Safety and efficacy of pembrolizumab monotherapy in patients with previously treated advanced gastric and gastroesophageal junction cancer: phase 2 clinical KEYNOTE-059 trial. JAMA Oncol 2018; 4 (5): e180013. doi: 10.1001/jamaoncol.2018.0013.

4. Shah MA, Kojima T, Hochhauser D et al. Efficacy and safety of pembrolizumab for heavily pretreated patients with advanced, metastatic adenocarcinoma or squamous cell carcinoma of the esophagus: the phase 2 KEYNOTE-180 study. JAMA Oncol 2019; 5 (4): 546–550. doi: 10.1001/jamaoncol.2018.5441.

5. Kojima T, Shah MA, Muro K et al. Pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer: phase III KEYNOTE-181 study. J Clin Oncol 2019; 38 (35): 4138–4148. doi: 10.1200/JCO.20.01 888.

6. Shitara K, Özgüroğlu M, Bang YJ et al. Pembrolizumab versus paclitaxel for previously treated, advanced gastric or gastro-oesophageal junction cancer (KEYNOTE-061): a randomised, open-label, controlled, phase 3 trial. Lancet 2018; 392 (10142): 123–133. doi: 10.1016/S0140-6736 (18) 31257-1.

7. Kato K, Shah MA, Enzinger P et al. KEYNOTE-590: phase III study of first-line chemotherapy with or without pembrolizumab for advanced esophageal cancer. Futur Oncol 2019; 15 (10): 1057–1066. doi: 10.2217/fon-2018-0609.

8. Kato K, Cho BC, Takahashi M et al. Nivolumab versus chemotherapy in patients with advanced oesophageal squamous cell carcinoma refractory or intolerant to previous chemotherapy (ATTRACTION-3): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 2019; 20 (11): 1506–1517. doi: 10.1016/S1470-2045 (19) 30626-6.