Feasibility of Induction DCF plus Nivolumab Followed by Conversion Surgery for Initially Unresectable Esophageal Cancer

Background: This study evaluated the feasibility and treatment outcomes of induction chemotherapy using a combination of docetaxel, cisplatin, and 5-fluorouracil (DCF) plus nivolumab (referred to as IC-DCF+Nivo) in patients with initially unresectable esophageal cancer.Methods: A total of 23 patients received IC-DCF+Nivo.The primary endpoint was the rate of conversion to resectable disease and subsequent surgery.Results: Eighteen patients (78%) completed all 3 cycles of IC-DCF+Nivo.Fourteen patients (61%) were judged resectable after treatment.Of these, 10 patients (44%) underwent conversion surgery, with R0 resection achieved in 9 cases and R1 in 1 case (followed by definitive chemoradiotherapy [dCRT]).One patient experienced disease progression prior to surgery, and 3 were still awaiting surgery at the time of analysis.Four patients (17%) remained unresectable and received either dCRT (n=3) or chemotherapy (n=1).Among them, 1 patient later underwent delayed conversion surgery.Conclusion: Induction therapy with DCF plus nivolumab appears feasible and enables conversion surgery in a substantial proportion of patients with initially unresectable esophageal cancer.Session 10