PD07.02. Real-World Outcomes of Adjuvant Nivolumab After Surgery Following NAC/NACRT for Esophageal Cancer

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ID: 326221
2026
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Abstract
Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background The CheckMate 577 trial demonstrated the efficacy of adjuvant nivolumab in patients with esophageal cancer who did not achieve a pathological complete response after neoadjuvant chemoradiotherapy (NACRT). In Japan, however, adjuvant nivolumab is also administered to patients treated with neoadjuvant chemotherapy (NAC), although its real-world effectiveness in this population has not been fully validated. We evaluated the real-world outcomes and clinical challenges of adjuvant nivolumab in patients with esophageal squamous cell carcinoma (ESCC) who underwent surgery after NAC or NACRT. Methods We retrospectively analyzed 65 patients with ESCC who underwent R0 resection following NAC or NACRT at our institution. To minimize immortal time bias, a landmark analysis was performed. Patients who remained recurrence-free for 180 days after surgery were classified according to treatment status at the 180-day landmark: ongoing nivolumab treatment (On) or no nivolumab (No). Recurrence-free survival (RFS) and overall survival (OS) were evaluated using Cox proportional hazards models. A 120-day landmark analysis was conducted as a sensitivity analysis. Results At the 180-day landmark, 46 patients (On: 27; No: 19) were eligible. Twelve RFS events occurred (On: 8; No: 4), yielding a hazard ratio (HR) of 1.53 (95% CI, 0.46–5.11; p=0.49). Twelve OS events were observed (On: 4; No: 4; discontinued [Stop]: 4), with an HR of 0.77 (95% CI, 0.11–5.50; p=0.80). In the 120-day landmark sensitivity analysis, 56 patients (On: 35; No: 21) were included, with 22 RFS events (On: 16; No: 6) (HR 1.86; 95% CI, 0.73–4.76; p=0.20). All patients in the discontinued (Stop) group stopped nivolumab due to recurrence. Conclusion In patients with esophageal cancer undergoing surgery after NAC/NACRT, adjuvant nivolumab may provide recurrence control in those able to continue treatment; however, early recurrence frequently precluded treatment continuation, limiting the number of patients who potentially benefit. The discontinued group primarily reflected recurrence-driven cessation rather than toxicity. The optimal role of adjuvant nivolumab in NAC-treated patients awaits the results of the ongoing JCOG2206 trial.
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Authors Hayato Shimoyama, Ryo Shibayama, Kentoku Fujisawa, Yusuke Ogawa, Shusuke Haruta, Masaki Ueno
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.124
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.124/70760596/doag077.124.pdf
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