Mostafa A Khalifa, Marafi Jammaa Ahmed, Hashim Talib Hashim, Aya Ahmed Shimal, Ahmad Omar Saleh, Salma Allam, Elian Khalafalla Awadalla, Hadeel Basheer Bin Saud, Jubran Khaled Alzedaar, Ali Dway, Roaa Abdultawab, Asala Hussein Al-Hadrawi, Mohammedbaqer Ghuraibawi
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引用次数: 0
Abstract
Background: Esophageal cancer (EC) remains a highly aggressive malignancy with a poor prognosis despite advancements in treatment. Toripalimab, a PD-1 inhibitor, has demonstrated the potential to improve clinical outcomes. This systematic review and meta-analysis assess the efficacy and safety of Toripalimab in EC.
Methods: Following PRISMA 2020 guidelines, we conducted a systematic review and meta-analysis, searching PubMed, Embase, Scopus, ScienceDirect, and Google Scholar up to January 2025. Eligible studies evaluated Toripalimab in esophageal cancer, including randomized controlled trials and non-randomized controlled trials. Primary outcomes included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR), while safety outcomes assessed treatment-related adverse events. Data were synthesized using random-effects models, with heterogeneity evaluated via Cochrane's Q and I2 statistics.
Results: The pooled analysis included six studies involving 678 patients. Toripalimab demonstrated promising efficacy, with a Complete Response (CR) rate of 33%, Partial Response (PR) rate of 36%, pathological complete response (pCR) rate of 30%, and major pathological response (MPR) rate of 46%. The R0 resection rate was 87%, while OS and PFS rates were reported at 78% and 50%, respectively. Anemia (56%), alopecia (54%), leukopenia (54%), and fatigue (30%) were the most frequently reported adverse effects. Other common adverse effects included nausea (29%), constipation (18%), and vomiting (20%).
Conclusions: Toripalimab demonstrates significant potential in treating esophageal cancer, with favorable response rates and survival outcomes. However, the high incidence of adverse effects highlights the need for supportive care and ongoing research. While based on limited sample sizes and single-arm studies that may introduce bias and affect generalizability in this review, we provide valuable preliminary insights into toripalimab's potential, highlighting the need for larger randomized trials to build on these findings.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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