Kết quả bước đầu hoá trị kết hợp pembrolizumab bước một ung thư thực quản biểu mô vảy giai đoạn IV

Abstract

Pembrolizumab is an immune checkpoint inhibitor that has been widely used in the treatment of various malignancies, including esophageal cancer. This longitudinal case-series study was conducted on 81 patients to evaluate the efficacy and safety of pembrolizumab combined with chemotherapy as first-line treatment for advanced esophageal cancer at K Hospital from January 2024 to June 2025. The mean age of the study population was 59.8 ± 7.5 years old, with 67.9% of patients younger than 65 years old. Among the 45 patients who underwent PD-L1 testing, 46.7% had a CPS < 1, 15.6% had a CPS from 1 to < 10 and 37.7% had a CPS ≥ 10. After three treatment cycles, the partial response rates at the primary tumor, lymph nodes, and metastatic lesions were 60.5%; 64.2%; and 61.7%; respectively. In addition, clinical symptoms improved markedly after treatment, including pain reduction, improvement in dysphagia, and weight gain. Hematologic toxicity was the most common adverse event, mainly consisting of anemia and neutropenia; however, the rate of grade ≥ 3 toxicities remained low. Immune-related adverse events were less frequent, primarily immune-mediated hepatitis and interstitial pneumonitis, most of which were mild to moderate in severity and manageable. These findings suggest that first-line pembrolizumab combined with chemotherapy demonstrates promising early efficacy and a manageable safety profile in patients with stage IV esophageal squamous cell carcinoma in real-world clinical practice in Vietnam.