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Peer-reviewedCC BY 4.0Frontiers in Immunology

Efficacy and safety analysis of consolidation immunotherapy following definitive concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma

  • Wanming Liu1
  • Qian Zhu2
  • Siyuan Xu3
  • Juan Chen1
  • Dianjun Wang4
  • Ting Wu4
  • Jun Shen5
  • Yiyao Zhu6
  • Zhifu Chen4
  • Yan Liu6
  • Guofang Wang3
  • Chaoyang Wu1
1 more authors
  • Yan Wang1
6 affiliations
  1. 1Department of Radiation Oncology, The People’s Hospital Affiliated to Jiangsu University
  2. 2Department of Oncology, Yangzhong People’s Hospital
  3. 3Danyang Hospital of Traditional Chinese Medicine
  4. 4Department of Pathology, The People’s Hospital Affiliated to Jiangsu University
  5. 5Jurong People’s Hospital
  6. 6College of Clinical Medicine and Medical Laboratory, Jiangsu University
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Abstract

Background: Definitive concurrent chemoradiotherapy (dCRT) is standard for locally advanced esophageal squamous cell carcinoma (ESCC), but recurrences remain common. Evidence for consolidation immunotherapy after dCRT is limited. This study evaluated the efficacy and safety of consolidation immunotherapy after dCRT and explored the association between programmed death-ligand 1 (PD-L1) expression and treatment outcomes.

Methods: This multicenter retrospective cohort included ESCC patients who completed dCRT without progression and received consolidation chemotherapy alone or with a programmed death-1 (PD-1) inhibitor followed by maintenance (July 2019–December 2024). Inverse probability of treatment weighting (IPTW) adjusted for baseline differences. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs) were compared. PD-L1 expression was assessed by combined positive score (CPS) in evaluable tissue.

Results: Among 96 patients, 45 received consolidation chemotherapy plus a PD-1 inhibitor followed by maintenance and 51 received consolidation chemotherapy alone. Median OS (43.1 vs. 26.0 months; P = 0.014) and PFS (25.4 vs. 9.6 months; P = 0.014) were longer with immunotherapy. After IPTW, OS (37.6 vs. 25.6 months; P = 0.018) and PFS (12.7 vs. 9.2 months; P = 0.037) remained significant. ORR was higher with immunotherapy (60.0% vs. 27.4%; P = 0.001). PD-L1 was evaluable in 38 patients; subgroup analyses were exploratory. Grade ≥3 TRAEs did not differ significantly (17.8% vs. 23.5%; P = 0.660).

Conclusion: Consolidation chemotherapy plus a PD-1 inhibitor followed by maintenance after dCRT was associated with longer OS and PFS in locally advanced ESCC, with comparable grade ≥3 TRAEs. PD-L1 analyses were inconclusive because few patients had evaluable tissue. These findings require validation in larger cohorts.

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Cite

BibTeXRIS
BibTeX
@article{liu2026efficacy,
  title = {{Efficacy and safety analysis of consolidation immunotherapy following definitive concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma}},
  author = {Wanming Liu and Qian Zhu and Siyuan Xu and Juan Chen and Dianjun Wang and Ting Wu and Jun Shen and Yiyao Zhu and Zhifu Chen and Yan Liu and Guofang Wang and Chaoyang Wu and Yan Wang},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1983549},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1983549/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Efficacy and safety analysis of consolidation immunotherapy following definitive concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
AU  - Wanming Liu
AU  - Qian Zhu
AU  - Siyuan Xu
AU  - Juan Chen
AU  - Dianjun Wang
AU  - Ting Wu
AU  - Jun Shen
AU  - Yiyao Zhu
AU  - Zhifu Chen
AU  - Yan Liu
AU  - Guofang Wang
AU  - Chaoyang Wu
AU  - Yan Wang
PY  - 2026
DA  - 2026/10/19
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1983549
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1983549/full
AB  - Background: Definitive concurrent chemoradiotherapy (dCRT) is standard for locally advanced esophageal squamous cell carcinoma (ESCC), but recurrences remain common. Evidence for consolidation immunotherapy after dCRT is limited. This study evaluated the efficacy and safety of consolidation immunotherapy after dCRT and explored the association between programmed death-ligand 1 (PD-L1) expression and treatment outcomes.  Methods: This multicenter retrospective cohort included ESCC patients who completed dCRT without progression and received consolidation chemotherapy alone or with a programmed death-1 (PD-1) inhibitor followed by maintenance (July 2019–December 2024). Inverse probability of treatment weighting (IPTW) adjusted for baseline differences. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs) were compared. PD-L1 expression was assessed by combined positive score (CPS) in evaluable tissue.  Results: Among 96 patients, 45 received consolidation chemotherapy plus a PD-1 inhibitor followed by maintenance and 51 received consolidation chemotherapy alone. Median OS (43.1 vs. 26.0 months; P = 0.014) and PFS (25.4 vs. 9.6 months; P = 0.014) were longer with immunotherapy. After IPTW, OS (37.6 vs. 25.6 months; P = 0.018) and PFS (12.7 vs. 9.2 months; P = 0.037) remained significant. ORR was higher with immunotherapy (60.0% vs. 27.4%; P = 0.001). PD-L1 was evaluable in 38 patients; subgroup analyses were exploratory. Grade ≥3 TRAEs did not differ significantly (17.8% vs. 23.5%; P = 0.660).  Conclusion: Consolidation chemotherapy plus a PD-1 inhibitor followed by maintenance after dCRT was associated with longer OS and PFS in locally advanced ESCC, with comparable grade ≥3 TRAEs. PD-L1 analyses were inconclusive because few patients had evaluable tissue. These findings require validation in larger cohorts.
SN  - 1664-3224
ER  -