The short-term efficacy and safety of neoadjuvant Sintilimab combined with chemotherapy for resectable gastroesophageal junction adenocarcinoma

• Published in: Langenbeck's archives of surgery 2024-12, Vol.410 (1), p.5, Article 5
• Main Authors: Chen, Liji, Zhang, Shifa, Ma, Hongmei, Zhong, Kaize, Yang, Dongbao, Sun, Jiuhe, Liu, Hongfeng, Song, Ru, Cai, Haibo
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adult; Aged; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cardiac Surgery; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - therapy; Esophagogastric Junction - pathology; Female; General Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach Neoplasms - therapy; Thoracic Surgery; Traumatic Surgery; Treatment Outcome; Vascular Surgery
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-024-03576-6

Introduction To explore whether neoadjuvant Sintilimab is suitable for patients with gastroesophageal junction (GEJ) adenocarcinoma, we designed this study to evaluate the short-term efficacy and safety of neoadjuvant Sintilimab in combination with chemotherapy for resectable GEJ adenocarcinoma. Methods We retrospectively collected data on patients with GEJ adenocarcinoma who underwent surgery after receiving neoadjuvant immunotherapy combined with chemotherapy at Jining First People’s Hospital between October 2020 and October 2023. The primary endpoint was complete pathological response (pCR) rate; secondary endpoints: major pathological response (MPR) rate, neoadjuvant therapy-related adverse events (AES), the safety of surgery, Postoperative Complications, and overall survival (OS). Results 24 eligible patients were enrolled in the study and achieved a pCR rate of 16.7%. The treatment-related AES was manageable. The median time interval between the end of neoadjuvant therapy and surgery was 35 days (28–81 days), R0 resection rate was 100%. The most common postoperative complications in the study were pneumonia ( n  = 11, 45.8%). Median follow-up was 13.5(interquartile range: 8.00, 25.50) months, Kaplan–Meier survival analysis showed median OS was not reached. Conclusions It was safe and effective for resectable GEJ adenocarcinoma to undergo neoadjuvant Sintilimab combined with chemotherapy followed by surgery, and long-term efficacy needs to be confirmed by further follow-up.