| dc.description.abstract | Introduction: In cases of resectable esophageal cancer, neoadjuvant immune checkpoint inhibitors and chemotherapy have been examined. Nonetheless, conflicting findings have been found in subsequent research. Thus, meta-analysis was the main purpose to methodically evaluate the safety and effectiveness profiles of immune treatment and chemotherapy combinations in individuals with esophageal cancer (EPC) or gastro-esophageal junction cancer (GEJC).
Method: Through a combination of MeSH (Medical Subject Headings) and keyword searches, “esophageal cancer”, “chemotherapy combination”, and “immunotherapy combination” in several databases, including the Google scholar, Researchgate, PubMed, and ClinicalTrials.gov websites, several articles were thoroughly reviewed and clinical randomized controlled trials (RCTs) were gathered by 2022. The Cochrane Methods were used to standardize the selection process, collect data from the studies, and evaluate the superiority of evidence and risk of bias. The primary measures were the estimated 95% CIs for the hazard ratio (HR) and odds ratio (OR) for overall survival (OS), progression-free survival (PFS), overall adverse events (OAE), and severe adverse events (SAE). R studio was used to evaluate the results, and online RobVis was also used for bias analysis.
Result: This meta-analysis looked at 15 RCTs with a total of 4,021 individuals to determine the effectiveness and safety of immunotherapy and chemotherapy for esophageal cancer. The outcomes demonstrated that the chemotherapy and immunotherapy treatment was linked with an overall risk for OS [HR = 0.85, 95% CI: 0.72–1.00; p < 0.71], PFS [HR = 0.94, 95% CI: 0.80–1.11]; p < 0.001], SAE (OR) = [0.99, 95% CI: 0.58–1.70; p = 0.08] and OAE (OR) = [0.72, 95% CI: 0.36–1.44; p = <0.01]. To determine the final result, Random Effects Model was utilised. The adverse event profile consisted of a combination of severe forms, such as anemia, thrombocytopenia, neutropenia, and diarrhea, among other types. Thankfully, toxicities were within tolerable limits.
Conclusion: This research indicates that individuals with advanced, untreatable, or metastatic EPC/GEJ who have not got any conventional prior treatment will clearly benefit from immunotherapy and chemotherapy combination. Nonetheless, there is a significant chance that immunotherapy and chemotherapy can cause adverse responses, therefore more research on the management of untreated, incurable, advanced, or metastatic EPC/GEJ is necessary. | en_US |
