Neoadjuvant Chemoradiotherapy With or Without Sintilimab for Esophageal Squamous Cell Carcinoma
Xuefeng Leng, MD, PhD, Sichuan Cancer Hospital & Institute, Chengdu, China, explains results from the phase 3 SCIENCE trial. This trial evaluated the use of chemoradiotherapy and sintilimab, compared to chemotherapy in the neoadjuvant setting for patients with locally advanced thoracic esophageal squamous cell carcinoma. The results found that neoadjuvant chemoradiotherapy with or without sintilimab improved pathological complete response rates when compared to chemotherapy with sintilimab in this setting.
These data were first presented at the 2025 ASCO Gastrointestinal Cancers Symposium.
Transcript:
I am Doctor Xuefeng Leng. I come from Sichuan Cancer Hospital & Institute, located in Chengdu, China. It’s a great honor to have the opportunity to have an oral presentation in the LBA session of this year’s ASCO GI.
Our study is the SCIENCE study. This study addresses the persistent challenge of high post-surgical recurrence rate in resectable locally advanced esophageal squamous cell carcinoma [ESCC] —because in China and in East Asia the most common esophageal cancer is the squamous cell carcinoma— despite the adoption of a new adjuvant chemoradiotherapy, like the CROSS trial, as the current standard of care. our trial investigates the potential of integrating the immune checkpoint inhibitor [ICI] like sintilimab with a standard treatment to enhance the therapeutic efficacy. Notably, this is the first 3-arm randomized trial to evaluate an ICI drug-based combination treatment modality against the standard neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma.
There are some key findings of this study. As the first study comparing neoadjuvant ICI combined with chemoradiotherapy and chemotherapy to standard neoadjuvant chemoradiotherapy, I think it provides critical insights that address or complement gaps left by existing neoadjuvant immunotherapy research. The study demonstrated that neoadjuvant chemoradiotherapy combined with sintilimab, a PD-1 inhibitor, achieved the highest pathological complete response, the pCR rate, with 60%, compared to chemoradiotherapy in our study which was 47.3%, and chemotherapy combined with the sintilimab which was 13% pCR. This underscores the significant enhancement in treatment efficacy with the addition of ICIs to chemoradiotherapy. Furthermore, this 3-arm trial highlights the potential for improved long-term survival and organ preservation in the future, advancing current neoadjuvant strategies for ESCC patients.
The findings suggest that integrating these ICI drugs into neoadjuvant chemoradiotherapy protocols could substantially improve the long-term survival rates by reducing the recurrence and possibly enabling organ preservation. This is only the preliminary results of our study, but it has the potential of that. This innovative approach of integration of immunotherapy with chemoradiotherapy could lead to more personalized and effective treatment strategies, ultimately translating into better patient outcomes over time. Thank you.
Source:
Leng X, He W, Lyu J, et al. Preliminary results from the multicenter, randomized phase III trial (SCIENCE): Comparing chemotherapy plus sintilimab and chemoradiotherapy plus sintilimab versus chemoradiotherapy for neoadjuvant treatment in resectable locally advanced esophageal squamous cell carcinoma. Presented at 2025 ASCO Gastrointestinal Cancers Symposium. January 23-25, 2025; San Francisco, CA. Abstract LBA329