Abstract:
Surgical resection is the most important treatment for patients with resectable esophageal cancer. However, selecting the perioperative treatment depending on the individual condition of the patient is of great importance because of the relatively high postoperative recurrence and metastatic rates of esophageal cancer. With the recognition of tumor immunotherapy, the use of immune checkpoint inhibitors has gradually moved from later-line and second-line treatment to first-line and even perioperative treatment. These agents are antibodies that work by blocking immune checkpoints to resist tumor immunosuppression, cause tumor shrinkage, and prevent recurrence. The anti-programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) antibody is the most commonly used immune checkpoint inhibitor. Many clinical trials are being conducted to investigate the application of neoadjuvant immunotherapy combined with chemotherapy or chemoradiotherapy for esophageal cancer. Existing data suggest that immunotherapy shows great potential in neoadjuvant treatment for esophageal cancer. However, clinical trials with larger sample sizes are still needed for further verification. At present, many problems remain to be solved, such as the identification of the optimal timing of treatment, treatment course, and biomarkers. This review summarized the findings of clinical studies on the application of neoadjuvant immunotherapy for esophageal cancer.