Lancet Oncol: Karelli Pearl Mono-second-line treatment of esophageal cancer Phase III study published, patients' risk of death reduced by 30% (ESCORT trial)

esophageal cancer is one of the highest mortality cancers in the world, and the incidence and mortality rate of esophageal cancer in China are very highThere are two main types of pathology for esophageal cancer: squamous and adenocarcinomaSquamous cancer is mainly distributed in developing countries, especially in China, accounting for more than 90% of esophageal squamous cancerMost of the first-line chemotherapy for advanced esophageal cancer is based on platinum or fluorourethane, with an effective rate of 40%-60%However, the median survival time (OS) of patients after first-line treatment failure is only 5-10 months, and there is no standard and effective treatment for second-line treatment, so we need to actively seek effective new drugsHappily, As a domestic innovation PD-1 monoantigen, The Carelli Pearl Monoantigen has achieved very encouraging results and full potential in exploring a variety of treatment modes for esophageal squamous cancerthe phase I study data for the treatment of esophageal cancer by the Carricoado single-line single-line single-line drug has been published in clinical cancer research, and according to the data of the first 30 patients with esophageal cancer, 10 patients achieved partial remission, the objective mitigation rate (ORR) reached 33.3%, and only 10% of drug-related adverse reactions above level 3It is worth mentioning that the efficacy and safety data of Carrelli-Jumono resistance are more significant than the phase I studies published for the treatment of esophageal cancer on second-line single-drug treatmentKarelli-Zuma-contrast researchers chose chemotherapy for second-line advanced/metastatic esophageal squamous cancer patients in ESCORT trial led by Professor Huang Mirror of the Oncology Hospital of the Chinese Academy of Medical Sciences and Professor Xu Jianming of the Academy of Medical Sciences Hospital (PLA 307 Hospital), and the results have just been published in the journal LancetyESCORT study began on May 10, 2017 and as of July 24, 2018, 457 (75%) of the 607 patients screened were randomly assigned to treatmentFor patients with advanced/metastatic esophageal squamous cancer who had previously received first-line chemotherapy failure, the trial group was randomly assigned to the trial group and the control group at a ratio of 1:1, and the subjects received The carelli-zhu monomonomono anti-monotherapy therapy (200 mg, every 2 weeks), and the control group was treated with chemotherapy programme selected by the researchers.: Dositasa (75 mg/m2, administered every 3 weeks) or Ilitricon (180 mg/m2, administered every 2 weeks), of which 228 patients received Carrellizumab and 220 patients received chemotherapyThe main endpoints of the study were total lifetime (OS), and the secondary endpoints included progression-free lifetime (PFS), objective mitigation rate (ORR), and so on457 patients, 228 were treated with camrelizumab and 220 were assigned to the chemotherapy protocol group (i.ethe control group) selected by the researchersAs of May 6, 2019, the median follow-up time was 8.3 months (IQR 4.1-12.8) in theCarrie-Zuma mono-anti-
group and 6.2 months (3.6-10.1) in the control chemotherapy group in the camrelizumab group, the median total survival was 8.3 months (95% CI 6.8-9.7), while in the chemotherapy group it was 6.2 months (5.7-6.9) (HR 0.71(95% CI 0.57-0.87) and the two-sided P-0.0010 The most common treatment-related adverse events at level 3 or more were anemia (camrelizumab group vs chemotherapy group: 6 cases (3 percent) vs 11 cases (5%),), liver dysfunction (4 cases (2 percent) vs 1 case (1 percent), diarrhea (3 cases , 1 percent, vs 9 cases , 4 percent) Of the 228 patients in the camrelizumab group, 37 (16%) had severe treatment-related adverse events, and 32 (15%) of the control group had treatment-related adverse events 10 treatment-related deaths occurred, 7 cases in the camrelizumab group (3 died of unknown causes, 1 person died of colitis, 1 person with abnormal liver function, 1 person with pneumonia, 1 case of myocarditis), and 3 cases (1%) in the chemotherapy group (2 cases of unexplained death) 1 case of gastrointestinal bleeding) the results of the results of each subgroup were basically the same as the overall results the above results show that for patients with advanced or metastatic esophageal squamous cancer who have previously failed first-line chemotherapy, the chemotherapy selected by the researchers with Carrelli-Zhu single anti-single therapy can significantly improve the patient's survival, extending the total survival of second-line patients by 2 months, HR close to 0.7 The safety data observed in the study were broadly consistent with previously published data and patient tolerance was good the search for Carreli zumain in esophageal squamous cancer has not ended, has only just begun
in fact, another study Carreli pearl monoantigen combined with apatine and chemotherapy (yew alcohol liposomes and naida platinum) first-line treatment of advanced esophageal squamous cancer phase II clinical study The study treated 30 patients in the group who could not be removed from late local or metastatic esophageal squamous cancer, giving Carrelli bemoatosan resistance to 200 mg, liposuction yewol 150 mg/m2 (day 1), nida platinum 50 mg/m2 (day 1) and Apatinib 250 mg (day1-14) for repeated treatment every 14 days, up to 6-9 cycles Maintenance therapy was then performed with Carrilizumab, appatinib, or both for current results (announced at the ASCO conference), the overall effectiveness of the 30 patients in the group was as high as 80% (of which 10% achieved clinical total remission), and the disease control rate (DCR) was as high as 96.7%, with high lyses expected results Suggestthat that in the future in the screening of suitable population premise, esophageal squamous cancer in the first-line treatment may be able to choose the "strong combination" (Carelli pearl mono-anti-anti-angiogenesis-targeted drug appatinib plus chemotherapy) treatment methods, to achieve precision treatment, so that more patients benefit