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Peer-reviewedCC BY 4.0Esophagus

Real-world treatments and outcomes in metastatic and recurrent esophageal squamous cell carcinoma in Japan: a retrospective analysis using the Millennial Medical Record database

  • Ken Kato1
  • Junice Ng2
  • Tomoyoshi Nakano3
  • Viriya Hantrakun4
  • See-Hwee Yeo5
  • Xiaowei Zhang6
  • Hiroya Takeuchi7
7 affiliations
  1. 1Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
  2. 2Health Economics and Outcomes Research, BeOne Medicines, Ltd., Singapore, Singapore
  3. 3Medical Affairs, BeOne Medicines, Ltd., Tokyo, Japan
  4. 4Real World Solutions, IQVIA Solutions Asia, Bangkok, Thailand
  5. 5Real World Solutions, IQVIA Solutions Asia, Singapore, Singapore
  6. 6Statistics, BeOne Medicines, Ltd., Beijing, China
  7. 7Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka Japan
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Abstract

Background: Esophageal squamous cell carcinoma (ESCC) remains a significant clinical challenge in Japan. Real-world data on treatment patterns and outcomes, particularly for patients unfit for cisplatin, remain limited. This study evaluated characteristics, treatments, and outcomes of patients newly diagnosed with metastatic ESCC (mESCC) or recurrent ESCC (rESCC).

Methods: A retrospective cohort analysis was conducted using the Millennial Medical Record database (December 2021–June 2024), including patients with m/rESCC. Patients receiving first-line (1 L) systemic therapy were categorized into cisplatin or non–cisplatin groups. Key outcomes included time-to-treatment discontinuation and overall survival (OS).

Results: Among 155 patients, 52.3% had mESCC and 47.7% had rESCC; 31.0% received 1 L systemic therapy, 46.4% underwent surgery or radiotherapy, and 22.6% received no treatment. Among those receiving 1 L therapy, 58.3% were treated with immune checkpoint inhibitors (ICIs), either in combination with chemotherapy or alone. Non–cisplatin patients were older with greater comorbidity burden; ~33.3% receiving ICI monotherapy and 27.8% dual ICI therapy. In contrast, 56.7% of patients in the cisplatin group received a cisplatin–ICI combination. Treatment discontinuation was more frequent with cisplatin than non-cisplatin therapy (73.3% vs. 55.6%), despite longer median treatment duration (75 vs. 47 days). Twelve-month OS was higher with cisplatin than non‑cisplatin regimens (92.1% vs. 75.0%).

Conclusions: In this real-world Japanese study, cisplatin-based regimens were commonly used for m/rESCC. Many patients who did not receive cisplatin had differing outcomes. This highlights the unmet need for better-tolerated alternatives for cisplatin-unfit patients with ESCC in Japan.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01233-z.

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Cite

BibTeXRIS
BibTeX
@article{kato2026realworld,
  title = {{Real-world treatments and outcomes in metastatic and recurrent esophageal squamous cell carcinoma in Japan: a retrospective analysis using the Millennial Medical Record database}},
  author = {Ken Kato and Junice Ng and Tomoyoshi Nakano and Viriya Hantrakun and See-Hwee Yeo and Xiaowei Zhang and Hiroya Takeuchi},
  journal = {Esophagus},
  year = {2026},
  month = jul,
  doi = {10.1007/s10388-026-01233-z},
  url = {https://doi.org/10.1007/s10388-026-01233-z},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Real-world treatments and outcomes in metastatic and recurrent esophageal squamous cell carcinoma in Japan: a retrospective analysis using the Millennial Medical Record database
AU  - Ken Kato
AU  - Junice Ng
AU  - Tomoyoshi Nakano
AU  - Viriya Hantrakun
AU  - See-Hwee Yeo
AU  - Xiaowei Zhang
AU  - Hiroya Takeuchi
PY  - 2026
DA  - 2026/07/20
JO  - Esophagus
DO  - 10.1007/s10388-026-01233-z
UR  - https://doi.org/10.1007/s10388-026-01233-z
AB  - Background: Esophageal squamous cell carcinoma (ESCC) remains a significant clinical challenge in Japan. Real-world data on treatment patterns and outcomes, particularly for patients unfit for cisplatin, remain limited. This study evaluated characteristics, treatments, and outcomes of patients newly diagnosed with metastatic ESCC (mESCC) or recurrent ESCC (rESCC).  Methods: A retrospective cohort analysis was conducted using the Millennial Medical Record database (December 2021–June 2024), including patients with m/rESCC. Patients receiving first-line (1 L) systemic therapy were categorized into cisplatin or non–cisplatin groups. Key outcomes included time-to-treatment discontinuation and overall survival (OS).  Results: Among 155 patients, 52.3% had mESCC and 47.7% had rESCC; 31.0% received 1 L systemic therapy, 46.4% underwent surgery or radiotherapy, and 22.6% received no treatment. Among those receiving 1 L therapy, 58.3% were treated with immune checkpoint inhibitors (ICIs), either in combination with chemotherapy or alone. Non–cisplatin patients were older with greater comorbidity burden; ~33.3% receiving ICI monotherapy and 27.8% dual ICI therapy. In contrast, 56.7% of patients in the cisplatin group received a cisplatin–ICI combination. Treatment discontinuation was more frequent with cisplatin than non-cisplatin therapy (73.3% vs. 55.6%), despite longer median treatment duration (75 vs. 47 days). Twelve-month OS was higher with cisplatin than non‑cisplatin regimens (92.1% vs. 75.0%).  Conclusions: In this real-world Japanese study, cisplatin-based regimens were commonly used for m/rESCC. Many patients who did not receive cisplatin had differing outcomes. This highlights the unmet need for better-tolerated alternatives for cisplatin-unfit patients with ESCC in Japan.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01233-z.
SN  - 1612-9059
SN  - 1612-9067
ER  -