DISCUSSION
breast carcinoma, tumor, neutropenia, toxicity, 18.8%Anemia, ESCC, squamous cell carcinoma, Neutropenia
BREAST CARCINOMA, TUMOR, NEUTROPENIA, DISEASE, EVENT, ADVERSE EVENT, SQUAMOUS CELL CARCINOMA, NEUTROPENIA, ESOPHAGUS CARCINOMA
Paclitaxel antitumor drugs include paclitaxel, docetaxel, paclitaxel liposomes, and nab‐paclitaxel, which belongs to the new anti‐microtubule drugs. Notably, nab‐paclitaxel combines the drug paclitaxel with albumin, which requires no special solvent, is easy to use, has low toxicity and increases antitumor activity. Among them, nab‐paclitaxel was firstly approved in the United States for the therapy of breast carcinoma in 2005.Nab‐paclitaxel exploits endogenous albumin transmission pathway to enhance the transportation across the monolayer endothelial cells and increase the penetration of paclitaxel to tumor cells, when compared to the conventional paclitaxel.Clinical studies of nab‐paclitaxel in the advanced or recurrent ESCC have been conducted in several centers (Table Studies on nab‐paclitaxel with or without radiotherapy in esophagus carcinoma.Toxicity(≥ Grade 3)260 mg/m300 mg/m340 mg/mD1, Q3W250 mg/mD1, Q3WCisplatinNeutropenia, 6.0%Vomiting, 3.0%Neuropathy, 3.0%ORR: 60.6%DCR: 87.9%100–150 mg/mD1, 8, Q3WCapecitabineor OxaliplatinLeucopenia, 24.2%Nausea/vomiting, 3.4%ORR: 37.0%DCR: 44.4%125 mg/mD1, 8, Q3WCisplatinLeukopenia, 37.5%Neutropenia, 37.5%Febrile Neutropenia, 18.8%Thrombocytopenia, 18.8%Anemia, 28.1%Anorexia, 12.5%Nausea/vomiting, 6.3%Diarrhea, 6.3%ORR: 50.0%DCR: 81.0%100 mg/mD1, 8, 22, 29CisplatinSurgeryAnemia, 8.6%Neutropenia, 11.4%Thrombocytopenia, 5.7%Febrile neutropenia, 8.6%Nausea/vomiting, 20%pCR: 13.3%1‐year OS: 90.0%2‐year OS: 70.0%3‐year OS: 43.3%60 mg/mD1, 8, 15, 22Q4WCisplatinRadiotherapyLeukopenia, 11.8%Anemia, 5.9%Esophagitis, 17.6%Anorexia, 5.9%Nausea, 5.9%Dysphagia, 5.9%Pneumonitis, 11.8%Cough, 11.8%ORR: 88.2%3‐year OS: 17.0%3‐year PFS: 35.0%260 mg/mD1, Q3WCamrelizumabCarboplatinSurgeryNeutropenia, 39.1%Leukopenia, 8.7%pCR: 25.0%ORR: 90.5%DCR: 100%100 mg/mD1, 8, 15, Q3WCamrelizumabCarboplatinSurgeryLeukopenia, 50.0%Anemia, 6.7%Thrombocytopenia, 6.7%60 mg/m75 mg/m90 mg/mD1, 8, 15, 22, 29CisplatinRadiotherapyNeutropenia, 8.3%Leukopenia, 33.3%ORR: 100%DCR: 100%1‐year OS: 100%2‐year OS: 91.7%3‐year OS: 83.3%1‐year PFS: 83.3%2‐year PFS: 83.3%3‐year PFS: 83.3%Abbreviations: D, day; DCR, disease control rate; MTD, maximum tolerated dose; Nab‐paclitaxel, nanoparticle albumin‐bound‐paclitaxel; ORR, overall response rate; OS, overall survival; pCR, pathologically complete response; PFS, progression‐free survival; SD, stable disease; Sq, squamous cell carcinoma; Q3W, every 3 weeks; Q4W, every 4 weeks.In our present study, no new safety event was observed and the adverse event was comparable to those previous studies.Up to now, there was few robust evidence of the antitumor effect of nab‐paclitaxel combined with radiotherapy in locally advanced ESCC. In a pilot trial, patients received radical radiotherapy and concurrent chemotherapy including weekly nab‐paclitaxel 60 mg/mIn a stage of immunotherapy, many prospective phase III studies with immune checkpoint inhibitors have demonstrated that anti‐program death‐1 antibodies can be recommended as a standard second‐line therapy for advanced ESCC.Our study provides robust evidence that weekly nab‐paclitaxel‐based chemoradiotherapy is safe and effective for patients with locally advanced ESCC. Due to the nab‐paclitaxel's low toxicity, more patients might complete the full course of chemoradiotherapy. However, we also have to admit that there exist few limitations. Firstly, the sample size of this study was relatively small; hence, future study in larger samples is urgently needed. Secondly, due to geographical factor, only patient with squamous cell carcinoma were enrolled in our study. Therefore, the conclusion is only applicable to ESCC.