UNASSIGNED: Nivolumab and pembrolizumab are anti-PD-1 antibodies that improve immunosuppression by binding to programmed death-1 (PD-1), leading to an antitumor effect. Randomized phase III trials have found these immune checkpoint inhibitors (ICIs) to be effective as second-line treatment. ATTRACTION-3, which compared nivolumab monotherapy with taxane monotherapy in patients with previously treated advanced ESCC, reported prolonged overall survival in the nivolumab group. KEYNOTE-181 found that overall survival was longer in patients with PD-L1-positive ESCC who received second-line treatment with pembrolizumab than in those who received chemotherapy. Sym004 and amivantamab are antibodies that target the epidermal growth factor receptor and have demonstrated efficacy in the treatment of other tumors in recent phase I studies. Furthermore, clinical trials on antibody-drug conjugates such as enfortumab vedotin and DS-7300 for solid tumors are currently ongoing.
UNASSIGNED: The standard first-line treatments for patients with advanced ESCC contain ICIs. Therefore, drugs with different mechanisms of action that can overcome resistance to ICIs are needed as second-line or later-line treatments to improve clinical outcomes in these patients.
■Nivolumab和pembrolizumab是抗PD-1抗体,通过与程序性死亡-1(PD-1)结合来改善免疫抑制,导致抗肿瘤效果。随机III期试验发现这些免疫检查点抑制剂(ICIs)作为二线治疗有效。ATTRACTION-3,比较了先前治疗过的晚期ESCC患者的nivolumab单药治疗与紫杉烷单药治疗,nivolumab组的总生存期延长.KEYNOTE-181发现,接受pembrolizumab二线治疗的PD-L1阳性ESCC患者的总生存期比接受化疗的患者长。Sym004和amivantamab是靶向表皮生长因子受体的抗体,在最近的I期研究中已证明在治疗其他肿瘤中的功效。此外,目前正在进行针对实体瘤的抗体-药物偶联物(如enfortumabvedotin和DS-7300)的临床试验.
■晚期ESCC患者的标准一线治疗包含ICIs。因此,需要具有不同作用机制的药物能够克服对ICIs的耐药性,作为二线或后期治疗,以改善这些患者的临床结局.