Three-arm phase II trial comparing camrelizumab plus chemotherapy versus camrelizumab plus chemoradiation versus chemoradiation as preoperative treatment for locally advanced esophageal squamous cell carcinoma (NICE-2 Study)

Yang Yang, Li Zhu, Yan Cheng, Zhichao Liu, Xiaoyue Cai, Jinchen Shao, Ming Zhang, Jun Liu, Yifeng Sun, Yin Li, Jun Yi, Bentong Yu, Hongjing Jiang, Hezhong Chen, Hong Yang, Lijie Tan, Zhigang Li, Yang Yang, Li Zhu, Yan Cheng, Zhichao Liu, Xiaoyue Cai, Jinchen Shao, Ming Zhang, Jun Liu, Yifeng Sun, Yin Li, Jun Yi, Bentong Yu, Hongjing Jiang, Hezhong Chen, Hong Yang, Lijie Tan, Zhigang Li

Abstract

Background: Preoperative chemoradiotherapy (CRT) with CROSS regimen has been the recommended treatment for locally advanced esophageal squamous cell carcinoma (ESCC). The addition of programmed cell death protein 1 (PD-1) inhibitor to preoperative CRT may further improve oncologic results. Preoperative camrelizumab plus chemotherapy has been demonstrated as a promising treatment modality based on results of the phase II NICE study (ChiCTR1900026240).

Methods: The NICE-2 study is designed as a three-arm, multicenter, prospective, randomized, phase II clinical trial, comparing camrelizumab plus chemotherapy (IO-CT) and camrelizumab plus CRT (IO-CRT) versus CRT as preoperative treatment for locally advanced ESCC. A total of 204 patients will be recruited from 8 Chinese institutions within 1.5 years. The primary endpoint is pathological complete response (pCR) rate and secondary endpoints include event-free survival (EFS), R0 resection rate, and adverse events.

Discussion: This is the first prospective randomized controlled trial to explore commonly used neoadjuvant treatments in clinical practice, which will provide high-level evidence of neoadjuvant treatment for patients with locally advanced ESCC. The purpose of this study is to establish the optimal modality of IO-CT, IO-CRT and CRT as preoperative treatment for locally advanced ESCC. The Institution Review Committee approved this study protocol in August 2021 and patient enrollment was started in September 2021.

Trial registration: ClinicalTrial.gov: NCT05043688 (August 29, 2021). The trial was prospectively registered.

Keywords: Camrelizumab; Chemoradiotherapy; Chemotherapy; Clinical trial; Esophageal cancer.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart of the NICE-2 study. ESCC: esophageal squamous cell carcinoma; IO: immunotherapy; CT: chemotherapy; CRT: chemoradiotherapy; CRE: clinical response evaluation; QOL: quality of life
Fig. 2
Fig. 2
Neoadjuvant treatment plans for the three arms. CRE: clinical response evaluation

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Source: PubMed

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