Abstract
Esophageal cancer is a type of digestive system tumor with a high degree of malignancy. In recent years, research has been conducted on immunotherapy, chemotherapy and radiation therapy for esophageal cancer. However, there are still shortcomings in the improvement of 5-year survival rates. In order to explore more therapy options, the present study evaluated the efficacy and safety of recombinant human-endostatin (rh-endostatin) combined with sintilimab and chemotherapy for the first-line treatment of locally advanced or metastatic esophageal squamous cell carcinoma (ESCC). This retrospective study included data from 31 patients with unresectable locally advanced or metastatic esophageal cancer treated between January 2019 and December 2023, and was approved by the First Affiliated Hospital of Nanjing Medical University (Nanjing, China). All patients received first-line treatment combining rh-endostatin with sintilimab, paclitaxel liposome and platinum. Following the completion of 6 cycles, maintenance therapy with sintilimab was administered until disease progression occurred. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) time, overall survival (OS) time and adverse events (AEs) were observed. Symptomatic or supportive care was administered as needed, according to the clinical discretion of the treating physician. As of July 17, 2024, the median follow-up time was 13.07 months, with a median PFS time of 8.30 months (95% confidence interval, 3.442-13.158 months). For these 31 patients, the ORR was 67.7% (21/31), while the DCR was 93.5% (29/31). The median OS time reached 23.07 months. Furthermore, 77.4% of patients experienced at least one treatment-related AE (TRAE), and grade 3 TRAEs occurred in 8 patients (25.8%). No unexpected AEs were observed. In conclusion, rh-endostatin combined with sintilimab and chemotherapy exhibited positive efficacy and safety in patients with advanced ESCC, providing a promising treatment regimen for these patients.