Real‐World Efficacy of Nab‐Paclitaxel Plus Capecitabine and a PD ‐1 Inhibitor in Metastatic or Locally Advanced Esophageal Cancer

Background Over half of esophageal cancer (EC) cases occur in China, where paclitaxel and platinum agents have become the preferred chemotherapeutic regimen for EC patients. However, there is a clinical need for a non‐platinum‐based therapeutic option. Methods Cases were collected from Sun Yat‐sen University Cancer Center between January 2019 and November 2023. Patients with metastatic or locally advanced EC received 4–6 cycles of chemo‐immunotherapy, including nab‐paclitaxel, capecitabine, and a programmed death receptor 1 (PD‐1) inhibitor, with or without subsequent surgery, radiotherapy, or maintenance therapy. The objective response rate (ORR), disease control rate (DCR), progression‐free survival (PFS), pathological complete response (pCR), complete (R0) resection rate, and major pathologic response (MPR) were assessed. Results Among the 72 patients retrospectively analyzed, the median PFS was 24.7 months (95% confidence interval: 7.0–42.3 months). 75% of patients were regarded as responders, with an ORR of 66.7% in 42 patients with measurable lesions. The 6‐month, 1‐year, and 2‐year PFS rates (DCRs) were 100%, 96.2%, and 67.9%, respectively. In total, 9 patients underwent surgery, and 29 patients received radiotherapy following the regimen. The R0 resection rate was 77.8%, while both pCR and MPR were 66.7%. The most common adverse events were myelosuppression (27.8%) and liver dysfunction (25.0%). Conclusion Our study demonstrated that the combination of nab‐paclitaxel, capecitabine, and a PD‐1 inhibitor was an effective and tolerable strategy for EC patients and a promising first‐line or neoadjuvant treatment option.