Atezolizumab following definitive chemoradiotherapy in patients with unresectable locally advanced esophageal squamous cell carcinoma – a multicenter phase 2 trial (EPOC1802)

• DOI: 10.1038/s43018-025-00918-1
• Publication Date: 2025-02-19T10:03:10Z
• Authors: Hideaki Bando; Shogo Kumagai; Daisuke Kotani; Saori Mishima; Takuma Irie; Kota Itahashi; Yosuke Tanaka; Takumi Habu; Sayuri Fukaya; Masaki Kondo; Takahiro Tsushima; Hiroki Hara; Shigenori Kadowaki; Ken Kato; Keisho Chin; Kensei Yamaguchi; Shun-ichiro Kageyama; Hidehiro Hojo; Masaki Nakamura; Hidenobu Tachibana; Masashi Wakabayashi; Makoto Fukui; Nozomu Fuse; Shohei Koyama; Hiroyuki Mano; Hiroyoshi Nishikawa; Kohei Shitara; Takayuki Yoshino; Takashi Kojima
• Keywords: Atezolizumab; Chemoradiotherapy

Platinum-based definitive chemoradiotherapy (dCRT) is the standard treatment for patients with unresectable locally advanced esophageal squamous cell carcinoma (ESCC) that invades aorta, vertebral body or trachea; however, complete response rates remain low (11–25%), leading to poor survival. To evaluate additive efficacy of anti-PD-L1 antibody drug atezolizumab, we conducted a phase 2, multicenter, single-arm trial 1 year atezolizumab following dCRT in 40 ESCC recruited from seven Japanese centers (UMIN000034373). The confirmed (cCR) rate (primary end point) first consecutive 38 was 42.1% (90% CI 28.5–56.7%). Regarding secondary points, median progression-free survival and 12-month all were 3.2 months 29.6%, respectively, preliminary overall short-term follow-up 31.0 65.8%, respectively. Other points evaluated included cCR determined by an investigator's assessment locoregionally recurrent cohort, central assessment, incidence adverse events. No treatment-related death occurred during study. Atezolizumab monotherapy after resulted promising rate, although long-term data are required. Bando et al. perform II platinum-based report 42%.