Anti-PD-1 Inhibitor for the Treatment of Esophageal Cancer Refractory or Intolerant to Previous Chemotherapy: A Meta-Analysis of Randomized Controlled Trials

Abstract

\n Background\n\nClinical studies have suggested that PD-1 inhibitor is useful in the management of advanced Esophageal Cancer. However, the efficacy and safety of Anti-PD-1 inhibitor for the treatment of advanced Esophageal Cancer is inconclusive. Thus, we conducted a meta-analysis aiming to comprehensively explore the effectiveness and safety of the therapeutic effects of PD-1 inhibitors on patients with advanced esophageal cancer.\nMethods & Materials:\n\nThe PubMed (since its inception), Cochrane library (since its inception), EMBASE (since its inception),and ClinicalTrials.gov (since its inception) were searched till 1st December 2020 for the randomized controlled trials (RCTs) that evaluated the effectiveness and safety of PD-1 inhibitors for patients with esophageal cancer. Two investigators independently performed study selection, data extraction and assessment of the methodological quality. RevMan 5.3 was applied statistical analysis.\nResults\n\nThree RCTs were included for this meta-analysis ,with a total of 1477 patients. Compared with chemotherapy, PD-1 inhibitors had superior objective response rates(Odds ratio(OR)\u2009=\u200914.96, 95% confidence interval (CI):0.47,476.97; P\u2009=\u20090.13). PD-1 inhibitors group had better overall survival compared to chemotherapy group(Hazard ratio(HR):0.80,95% CI:0.70,0.91,P\u2009=\u20090.0007) .The progression-free survival (HR:0.94,95% CI:0.71,1.26,P\u2009=\u20090.69) were similar between the two groups. The grade 3 or more adverse events rate were lower in the PD-1 inhibitors group as compared to those of chemotherapy group(OR:0.25,95% CI:0.13,0.46,P\u2009<\u20090.0001).\nConclusions\n\nOur study indicated that PD-1 inhibitors are efficacious and safe for the management of EC refractory or intolerant to previous chemotherapy.