What question did this study set out to answer?

This study evaluates the safety and efficacy of adebrelimab combined with chemoradiotherapy in resectable locally advanced esophageal squamous cell carcinoma.

May 30, 2026

Adebrelimab combined with concurrent chemoradiotherapy as neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma: A prospective, single-arm clinical trial.

Key Points

This study evaluates the safety and efficacy of adebrelimab combined with chemoradiotherapy in resectable locally advanced esophageal squamous cell carcinoma.
Prospective, single-arm trial with 32 eligible patients with resectable thoracic ESCC.
Regimen included adebrelimab (1200 mg IV every 3 weeks for 2 cycles) and concurrent chemoradiotherapy.
Primary endpoint was pathological complete response (pCR); secondary endpoints included major pathological response and safety.
Achieved 58.3% pathological complete response rate (14/24) among patients undergoing surgery.
91.7% major pathological response rate (22/24) observed.
Significant toxicities noted: 43.8% grade ≥3 leukopenia and common manageable non-hematological side effects.

Abstract

e16139 Background: The prognosis for patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) remains poor. While immune checkpoint inhibitors have shown efficacy in advanced disease, their synergistic potential with concurrent chemoradiotherapy (CRT) in the neoadjuvant setting for LA-ESCC requires prospective validation. This study aimed to prospectively evaluate the efficacy and safety of the PD-L1 inhibitor adebrelimab combined with concurrent CRT as a novel neoadjuvant strategy for resectable LA-ESCC. Methods: This was a prospective, single-arm trial. Eligible patients had resectable thoracic ESCC, clinically staged as cT2N+ or cT3-4a any N M0. The regimen comprised adebrelimab (1200 mg intravenously every 3 weeks for 2 cycles) plus concurrent CRT (weekly paclitaxel/carboplatin and radiotherapy totaling 41.4 Gy in 23 fractions). Radical esophagectomy was scheduled 4-8 weeks after neoadjuvant therapy completion. The primary endpoint was the pathological complete response (pCR; ypT0N0) rate. Key secondary endpoints included the major pathological response (MPR; ≤10% residual viable tumor) rate, R0 resection rate, and safety. Results: Between June 2024 and October 2025, 32 patients were enrolled (median age 64.6 years; 75.0% male; 75.0% stage III). Of these, 24 patients proceeded to surgery, achieving a 100% (24/24) R0 resection rate. The primary endpoint was met, with a pCR rate of 58.3% (14/24). The MPR rate was 91.7% (22/24). Pathological downstaging was profound: 87.5% (21/24) of patients achieved primary tumor (T-stage) downstaging (ypT < cT), and 66.7% (16/24) achieved nodal clearance (ypN0). Regarding safety, grade ≥3 leukopenia occurred in 43.8% (14/32) of patients, all of whom had concomitant grade ≥3 lymphopenia. Common non-hematological toxicities included nausea (58.1%), constipation (54.8%), decreased appetite (48.4%), and vomiting (41.9%), which were all grade 1-2 and manageable with supportive care. Conclusions: Neoadjuvant adebrelimab plus concurrent CRT demonstrated remarkable efficacy in LA-ESCC, yielding high rates of pCR (58.3%) and MPR (91.7%), alongside significant pathological downstaging. While hematologic toxicity requires vigilant management, the profound tumor regression achieved offers a promising new strategy for improving outcomes in this population. These compelling results warrant further validation in a phase III randomized controlled trial. Future studies should explore optimization of the chemotherapy component to potentially enhance tolerability. Clinical trial information: ChiCTR2400084445.

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