Cindilli monoto-resistance is expected to break through the iron triangle or become the fourth largest drug in esophageal cancer immunity.

The incidence of esophageal cancer is the seventh highest in the world, and the mortality rate is the 6thChina is a country with a high incidence of esophageal cancer, accounting for more than half of the world's morbidity and mortalityUnlike in Europe and North America, esophageal cancer pathology is mostly adenocarcinoma, more than 90% of China's esophageal cancer is scaly cancerAt present, clinical treatment mainly includes surgery, chemotherapy, radiotherapy and targeted therapyAbout half of the patients metastasized at the time of clinical diagnosis, so chemotherapy has become the standard treatment for advanced esophageal cancerHowever, whether esophageal squamous cell carcinoma or esophageal adenocarcinoma have inherent resistance to traditional treatment, first-line chemotherapy treatment response is limited, the application of targeted drugs in esophageal cancer treatment is very limited, the urgent need for new treatment methods to improve the prognosis of esophageal cancerImmunotherapy has brought revolutionary changes to other tumors, and although immunotherapy for esophageal cancer started late, it has also made great achievementsthe current CSCO guidelines recommend Paboli bead singumatin, Carelli zuma, navuliu singofa as a second-line immunotherapy drug for esophageal cancer, forming the iron triangle of immunotherapyThe domestic drug Cindili singantis also launched a shock on the second-line treatment of advanced esophageal squamous cancer, and achieved positive resultsIt is expected to be the fourth largest drug in esophageal cancer immunityLook at the new recommendations for esophageal cancer immunotherapyPaboli sepsis (scale cancer, PD-L1 CPS 10, 1A evidence)as one of the two giants of PD-1, Paboli zumas as a second-line treatment of patients with advanced esophageal syllin (CPS s 10) patients grade I recommendation (Class 1A evidence), its approval is based on THE UNDERlying phase III clinical study of UNDERLYZER-181KEYNOTE-181 is an international multicenter randomized controlled phase III clinical study in which the Chinese subgroup contributed 123 patients with recurrent locally advanced or metastatic esophageal cancer to random treatment with Paboli zuma (62 cases) or chemotherapy (61 cases)results showed that OS benefits were more significant in patients with esophageal syllin syds in China, with a 45% lower risk of death and three times higher than the overall study population (45% vs 15%, HR 0.55 and 0.85, respectively)recommended level: Patients with scale cancer and CPS s 10Promotions are recommended by Level III experts in the old guide for Level I, and the evidence level is adjusted from 2B to 1A Carellizumab (scale cancer, 1A evidence) Carellizumab is the first domestic immunotherapy drug approved for the treatment of advanced esophageal cancer in China The recommendation is mainly based on random, open, chemotherapy drug control, multicenter phase III clinical research ESCORT study results 2, as the first, largest sample of immunocheckpoint inhibitors in patients with advanced esophageal symbiotic cancer in China, ESCORT study included a total of 457 cases of first-line chemotherapy failure of late or metastusation Esophageal sylocutans patients (228 cases and 220 cases of chemotherapy, respectively), the trial results showed that the median OS in both groups was 8.3 months vs 6.2 months, and Carilli Zuma reduced the risk of death by about 30% THE ORR is 20.2% vs 6.4%, dOR is 7.4 months vs 3.4 months, and patients can benefit from Carillizumab therapy regardless of PD-L1 expression status In terms of safety, Carilli zumas are well tolerated, and the incidence of drug-related adverse events (TRAE) at level 3 and above is halved compared to the chemotherapy group (19.3% vs 39.5%), as recommended as a grade I grade (1A evidence) of esophageal scale cancer Navuli umonotol (scale cancer, IIA evidence) The ATTRACTION-3 study is a multicenter randomized global study that enrolled patients with advanced esophageal syllifes who progressed or intolerance after first-line fluorourery and platinum treatment to assess the efficacy and safety of navulieu monoantitherapy chemotherapy (doselate or yewol) The patients are mainly from Asia (about 96%) the OS extended in the Navuliu monotherapy group by 2.5 months (10.9 months vs 8.4 months, HR 0.77, p - 0.019) compared to the chemotherapy group The survival benefits of the Navuliu monotoreactor group were observed regardless of the level of expression of tumor PD-L1 Although there was no significant difference between the two groups of PFS (HR s 1.08), the longer duration of the bit-based remission in the Navuu monobinat group (DOR: 6.9 months vs 3.9 months) showed the advantages of immunotherapy The ORRs for both groups are 19% vs 22% respectively recommended level: Since the study did not enroll Chinese patients, the efficacy of Chinese patients needs further data validation Currently only Grade II recommendations are made for patients with scale cancer (evidence level 2A) Cindy Singli Singanti -
in the future ORIENT-2 is a random Phase II study In 190 patients with advanced esophageal syllifes who failed first-line treatment, 1:1 randomized doses of sequoia leachatol/iliticon standard dose chemotherapy were given to Cindili monotoresis or the researchers decided the median OS in both groups was 7.2 months vs 6.2 months (HR 0.70, P - 0.034), and the low-neutral lymphocytes were longer than the median OS in patients with low neutroly ophrate (NLR) patients (HR 0.54, P - 0.019) The Cindilly SLR group had a higher ORR, with 12.6% vs 6.3% in both groups In subgroups with PD-L1 (TPS) to 1%, the two ORRs are 20.2% vs 0, and PD-L1 vs 10% subgroups are 35.7% vs 0 The DOrs in both groups were 8.3 months vs 6.2 months, respectively As the data has just been published on ASCO, the updated guidelines do not contain Cindy supretic recommendations, but the results show that for patients with advanced esophageal squamous patients with late-stage first-line chemotherapy, Cindilla inthetades can significantly extend OS (7.2 months) and is safe compared to chemotherapy In view of the above research results, although the current lack of Cindili supresIII research data, compared with chemotherapy, Cindili salinhas has obvious clinical benefits, indicating that its treatment of advanced esophageal cancer has great potential, is expected to become the fourth largest drug in esophageal cancer immunotherapy Reference Source: 1 Guidelines for the diagnosis and treatment of esophageal cancer by the Chinese Society of Clinical Oncology (CSCO) 2020; 2 ; 3 Chen J, Luo S, Qin S, et al Pembrolizumab Versus MLoy in Patients with Advanced/Metastatic Adenocarcin or Squamous Cell Carcinoma of the The SanEus as Second-line Therapy: Analysis of the Chinese SubGroup in SUB-SUB-181 2019 ESMO, abstract 760P 4 Kato K, Cho BC, Takahashi M, et al Nivolumab versus sydd yn patients with advanced oeeal srefractor or intointoetos cell carcinomaorory or intorefore (ATTRACTION-3): a multi-centre, random, open-label 3 Lancet Oncol 2019;20(11):1506-1517 doi: 10.1016/S1470-2045 (19)30626-6.