767. INFLUENCE OF NEOADJUVANT IMMUNOTHERAPY-CHEMOTHERAPY ON PERIOPERATIVE OUTCOMES IN LOCALLY ADVANCED ESOPHAGEAL ADENOCARCINOMA

Abstract Background This study evaluates the perioperative outcomes of patients with locally advanced esophageal adenocarcinoma (EAC) who were treated with neoadjuvant immunotherapy (IO) and chemotherapy versus a matched cohort of patients that received neoadjuvant chemotherapy (NAC) alone. Methods A single center non-randomized phase II trial was undertaken in locally advanced (cT3-4 and/or N+) EAC and 49 patients completed neoadjuvant Avelumab + DCF (Docetaxel, Cisplatin, 5FU) and esophagectomy between 2/2018 and 2/2020. These patients were matched to contemporary patients (1/2018-6/2020) who met inclusion criteria but received neoadjuvant chemotherapy alone (NAC) with a comparable Docetaxel based. The postoperative outcomes were then compared between the two groups. Results Ninety-nine patients with locally advanced EAC underwent esophagectomy and meet enrolment criteria for this study. Of these patients, 50 received NAC alone 49 received IO+NAC. Baseline characteristics such as age, gender and clinical stage were comparable between groups. Operative approach and rate of MIE (~60%) was similar in both groups. Overall and major complication rate were similar between groups (50 vs. 51%, p=0.91; 20 vs. 26%, p=0.44 respectively) with concordant rates of anastomotic leak (6 [12%] vs. 6 [12%], p=0.86) and respiratory complications (13 [26%] vs. 11 [22%], p=0.68) in NAC alone and IO+NAC group respectively. There were no significant differences in the LOS and 30- and 90-days mortality rates between the two groups. Conclusion The addition of immunotherapy to neoadjuvant chemotherapy for locally advanced esophageal adenocarcinoma does not appear to significantly alter perioperative short-term outcomes after esophagectomy