Efficacy and safety of first-line PD-1/PD-L1 inhibitor–based therapy in esophageal squamous cell carcinoma: A systematic review and meta-analysis.

作者：Mannal Ahmed, MA Ali, Shabih Raza Farista, Vishan Das, Shazia Khan, Sadia Qazi, Eshal Atif, Mehmoona Zahid, Muhammad Atif Mazhar, Muhammad Umar Munir, Muhammad Aamir Riaz, Hira Naz, Sidra Naz · 发表于：Journal of Clinical Oncology · 年份：2026 · DOI：10.1200/jco.2026.44.19_suppl.113 · 研究领域：Esophageal Cancer Research and Treatment、Cancer Immunotherapy and Biomarkers、Colorectal and Anal Carcinomas

113 Background: First-line treatment of esophageal squamous cell carcinoma (ESCC) has evolved with PD-1/PD-L1 inhibitor–based regimens, but survival benefit estimates vary across trials due to differences in checkpoint agents, chemotherapy backbones, and PD-L1 subgroup definitions. Additional phase III trials and updated follow-up data now available prompted this updated meta-analysis to re-estimate efficacy with greater precision. Methods: PubMed, Embase, Scopus, and the Cochrane Library were searched from inception through 2 February 2026 for randomized controlled trials comparing PD-1/PD-L1 inhibitor–based therapy versus chemotherapy in first-line ESCC. Eligible trials reported OS and/or PFS as hazard ratios (HRs) with 95% CIs. Two reviewers independently screened and extracted data. Pooled HRs were calculated using random-effects models; heterogeneity was quantified by I² and τ². Publication bias was assessed by funnel plot. Robustness was evaluated using influence diagnostics (studentized residuals, DFFITS, Cook's distance, covariance ratio), Baujat, radial (Galbraith), and GOSH analyses. Results: Nine randomized phase III trials contributed 13 HR comparisons (N=7,713). PD-1/PD-L1 inhibitor–based therapy improved OS (pooled HR 0.70, 95% CI 0.66–0.74), with all individual comparisons favoring immunotherapy (HR range 0.58–0.77). PFS was also improved (pooled HR 0.64, 95% CI 0.60–0.68); most comparisons were statistically significant (HR range 0.56–0.67), with one estimate ...