Precision immunotherapy in oesophageal squamous cell carcinoma: Molecular pathogenesis and checkpoint inhibitor response prediction

Oesophageal squamous cell carcinoma (ESCC) remains a significant global health challenge due to its aggressive nature and poor prognosis. Recent advances in immunotherapy, particularly immune checkpoint inhibitors (ICIs), have revolutionized treatment paradigms. This review comprehensively examines the molecular pathogenesis of ESCC, highlighting key oncogenic pathways and immune evasion mechanisms. Furthermore, it explores the evolving landscape of biomarkers and predictive models for ICI response, emphasizing the critical role of precision immunotherapy in tailoring treatment strategies. A deeper understanding of these molecular and immunological underpinnings is essential for optimizing patient selection, overcoming resistance, and ultimately enhancing therapeutic efficacy in ESCC.