IMPACT OF PD-1 AND PD-L1 INHIBITORS ON PATIENT-REPORTED OUTCOMES IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA: A SYSTEMATIC REVIEW OF CLINICAL TRIALS
Author(s)
Sun Choi, PharmD, MS1, Wesley Wong, PharmD1, Philip Buck, PhD, MPH2, Jason Allaire, PhD1;
1Generativity Solutions Group, Emerald Isle, NC, USA, 2Generativity Solutions Group, Philadelphia, PA, USA
1Generativity Solutions Group, Emerald Isle, NC, USA, 2Generativity Solutions Group, Philadelphia, PA, USA
OBJECTIVES: Esophageal squamous cell carcinoma (ESCC) has a poor prognosis and causes symptoms such as dysphagia and weight loss that substantially impair patients’ health-related quality of life (HRQoL). For unresectable, recurrent, or metastatic ESCC, chemotherapy combined with an immune checkpoint inhibitor is recommended as preferred treatment and is widely used in real-world practice. This systematic literature review evaluated patient-reported outcomes (PROs) among ESCC patients treated with PD‑1/PD-L1 inhibitors across clinical trials.
METHODS: A systematic literature search was performed using the PubMed, Embase, and Cochrane Library databases, supplemented by Elicit, to identify clinical trial publications reporting the effects of PD-1/PD-L1 inhibitors on PROs in patients with ESCC. The search included all relevant publications available up to July 20, 2025. Studies were included if they met the following criteria: 1) conducted in patients with ESCC; 2) reported PROs, including HRQoL, as part of a clinical trial investigating PD-1/PD-L1 inhibitors; 3) published manuscripts in English.
RESULTS: A total of 18 ESCC clinical trial publications met eligibility criteria. The trials included nivolumab, tislelizumab, camrelizumab, sintilimab, and pembrolizumab; they assessed PROs using the EORTC QLQ-C30, QLQ-OES18, EQ-5D, and FACT-E questionnaires with follow-up durations ranging from 8 to 60 weeks. Overall, PD-1/PD-L1 inhibitor-based regimens consistently demonstrated maintenance or improvement in assessed PROs compared with chemotherapy alone. Nivolumab demonstrated maintenance or improvement in HRQoL. Tislelizumab showed significantly less worsening/maintenance in global health status and fatigue, as well as improved reflux symptoms. Camrelizumab and sintilimab demonstrated maintenance or improvement in HRQoL and ESCC-related symptoms (e.g., dysphagia, pain). Pembrolizumab generally maintained HRQoL with improvements in dysphagia and pain symptoms.
CONCLUSIONS: Clinical trial publications indicated that PD-1/PD-L1 inhibitors consistently maintained or improved PROs compared with chemotherapy alone in patients with ESCC. PD-1/PD-L1 inhibitors especially had a positive impact on global health status, functional domains, and key ESCC-related symptoms.
METHODS: A systematic literature search was performed using the PubMed, Embase, and Cochrane Library databases, supplemented by Elicit, to identify clinical trial publications reporting the effects of PD-1/PD-L1 inhibitors on PROs in patients with ESCC. The search included all relevant publications available up to July 20, 2025. Studies were included if they met the following criteria: 1) conducted in patients with ESCC; 2) reported PROs, including HRQoL, as part of a clinical trial investigating PD-1/PD-L1 inhibitors; 3) published manuscripts in English.
RESULTS: A total of 18 ESCC clinical trial publications met eligibility criteria. The trials included nivolumab, tislelizumab, camrelizumab, sintilimab, and pembrolizumab; they assessed PROs using the EORTC QLQ-C30, QLQ-OES18, EQ-5D, and FACT-E questionnaires with follow-up durations ranging from 8 to 60 weeks. Overall, PD-1/PD-L1 inhibitor-based regimens consistently demonstrated maintenance or improvement in assessed PROs compared with chemotherapy alone. Nivolumab demonstrated maintenance or improvement in HRQoL. Tislelizumab showed significantly less worsening/maintenance in global health status and fatigue, as well as improved reflux symptoms. Camrelizumab and sintilimab demonstrated maintenance or improvement in HRQoL and ESCC-related symptoms (e.g., dysphagia, pain). Pembrolizumab generally maintained HRQoL with improvements in dysphagia and pain symptoms.
CONCLUSIONS: Clinical trial publications indicated that PD-1/PD-L1 inhibitors consistently maintained or improved PROs compared with chemotherapy alone in patients with ESCC. PD-1/PD-L1 inhibitors especially had a positive impact on global health status, functional domains, and key ESCC-related symptoms.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR97
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Gastrointestinal Disorders, SDC: Oncology