Chinese expert consensus on perioperative immunotherapy for esophageal cancer (2024 Edition)

Title: Chinese expert consensus on perioperative immunotherapy for esophageal cancer (2024 Edition)
Edition: Updated
Classification: Experts consensus
Field: Treatment
Countries and regions: China
Guidelines users: Including but not limited to medical workers related to the surgical treatment of esophageal cancer in medical institutions at all levels.
Evidence classification method: The Evidence Retrieval and Evaluation Group evaluated the included randomized controlled trial studies using the Cochrane Reviewer′s Handbook 5.0.1 criteria, the included cohort studies using the Newcastle-Ottawa Scale, the diagnostic accuracy studies using the QUADAS-2, and the case-series studies using the United Kingdom's National Institute for Clinical Excellence Institute evaluation tool for case series studies. The evaluation process was completed independently by 2 individuals, and if disagreements existed, they were discussed together or resolved by consulting a third party. Quality of evidence and recommendations were graded using the grading of recommen-dations assessment, development and evaluation (GRADE) method.
Development unit: Chinese National Cancer Center; Chinese Association of Thoracic Surgeons; Chinese Society for Thoracic and Cardiovascular Surgery; Chinese Society for Diseases of the Esophagus
Registration time: 2024-02-20
Registration number: PREPARE-2024CN283
Purpose of the guideline: Neoadjuvant immune checkpoint blockade (ICB) is a new treatment approach that has gained traction in esophageal cancer patients. Neoadjuvant cancer therapy refers to the administration of cancer treatment before performing a curative surgery for patients who have not yet received any treatment for their condition. Neoadjuvant chemotherapy and radiotherapy aim to shrink tumors for better surgical outcomes. Recent evidence suggests neoadjuvant immunotherapy can enhance intratumoral and systemic anti-tumor immunity by expanding and transcriptionally modifying tumor-specific T-cell subclones. It provides a unique opportunity to study mechanisms and discover ICB response and resistance biomarkers, leading to better predictions of long-term clinical outcomes and the development of more effective ICB combination therapies. Since there is a scarcity of high-level evidence to guide, medical and ethical risks persist. The current consensus has been revised based on new and practice-changing data. The current updates are based on an evidence review and adhere to the guideline development processes. This consensus aims to quickly provide up-to-date recommendations to healthcare practitioners and the public on the most effective cancer care options available.