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Background and objectives <p>Neoadjuvant immunotherapy combined with chemotherapy or chemoradiotherapy has emerged as a promising approach in the treatment of esophageal cancer. However, there is a lack of comprehensive understanding regarding the clinical factors that can predict patient response to this therapy. The aim of this study was to develop a predictive model for assessing the efficacy of neoadjuvant immunotherapy in patients undergoing surgical treatment.</p> Methods <p>This study retrospectively enrolled 220 consecutive patients with preoperative immunotherapy combined chemotherapy or chemoradiotherapy. A logistic regression was used to evaluate the association between pathologic complete response (pCR) and endoscopic ultrasound parameters, constructing a predictive model for treatment response. Additional, overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method, and Cox regression analyses were introduced to explore the associations between EUS factors after neoadjuvant immunotherapy.</p> Results <p>Logistic regression analysis identified that the significant predictors of pCR were treatment regimen, negative biopsy findings, RECIST assessment, endoscopic ultrasound responder, and downstaging in uN. A predictive model including above five variables was generated, and area under the curve was 0.840(95%CI 0.78–0.89), this nomogram was also adequately validated internally. In the cox regression analyses, EUS responder was found to be a significant predictor of overall survival with a hazard ratio (HR) of 0.38(95%CI 0.15–0.98), whereas only pCR status was a significant predictor of PFS (HR 0.80; 95%CI 0.01–0.60).</p> Conclusions <p>EUS responder can serve as a valuable predictor of the efficacy of adjuvant immunotherapy combined with chemotherapy or chemoradiotherapy, as well as of survival outcomes.</p>

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Efficacy evaluation and prognostic prediction of endoscopic ultrasound for neoadjuvant immunotherapy in esophageal cancer

  • 期刊论文

  • 发表日期：

    2025年4月23日

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  • Qiao-na Liu,
  • Yu-fan Chen,
  • Guang-yu Luo,
  • Xu Zhang

摘要

Background and objectives

Neoadjuvant immunotherapy combined with chemotherapy or chemoradiotherapy has emerged as a promising approach in the treatment of esophageal cancer. However, there is a lack of comprehensive understanding regarding the clinical factors that can predict patient response to this therapy. The aim of this study was to develop a predictive model for assessing the efficacy of neoadjuvant immunotherapy in patients undergoing surgical treatment.

Methods

This study retrospectively enrolled 220 consecutive patients with preoperative immunotherapy combined chemotherapy or chemoradiotherapy. A logistic regression was used to evaluate the association between pathologic complete response (pCR) and endoscopic ultrasound parameters, constructing a predictive model for treatment response. Additional, overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method, and Cox regression analyses were introduced to explore the associations between EUS factors after neoadjuvant immunotherapy.

Results

Logistic regression analysis identified that the significant predictors of pCR were treatment regimen, negative biopsy findings, RECIST assessment, endoscopic ultrasound responder, and downstaging in uN. A predictive model including above five variables was generated, and area under the curve was 0.840(95%CI 0.78–0.89), this nomogram was also adequately validated internally. In the cox regression analyses, EUS responder was found to be a significant predictor of overall survival with a hazard ratio (HR) of 0.38(95%CI 0.15–0.98), whereas only pCR status was a significant predictor of PFS (HR 0.80; 95%CI 0.01–0.60).

Conclusions

EUS responder can serve as a valuable predictor of the efficacy of adjuvant immunotherapy combined with chemotherapy or chemoradiotherapy, as well as of survival outcomes.