Camrelizumab plus chemotherapy versus chemoradiotherapy as neoadjuvant therapy for resectable esophageal squamous cell carcinoma: Phase 2 randomized trial (REVO)
Several studies have evaluated PD-1 inhibitors plus chemotherapy as neoadjuvant treatment for locally advanced esophageal squamous cell carcinoma (ESCC), but comparative data with chemoradiotherapy (CRT) remain limited. This multicenter, randomized, open-label, phase 2 non-inferiority trial (REVO, NCT05007145) assessed the efficacy and safety of neoadjuvant camrelizumab plus chemotherapy (ICT) versus CRT in patients with resectable, locally advanced ESCC. A total of 104 patients were randomized to ICT (camrelizumab, nab-paclitaxel, cisplatin) or CRT (nab-paclitaxel, cisplatin, radiotherapy). The primary endpoint was pathologic complete response (pCR). ICT achieved a pCR rate of 32.7% versus 34.6% with CRT (rate ratio 0.94, 90% CI 0.6-1.49), demonstrating non-inferiority and meeting the pre-specified primary endpoint. Major pathologic response was observed in 42.3% of ICT patients and 57.7% of CRT patients, with R0 resection achieved in 100% of both groups. 1-year disease-free survival was 89.1% versus 78.2%, and 1-year overall survival was 100% versus 92.3% for ICT and CRT, respectively. Grade ≥3 treatment-related adverse events occurred in 19.2% of ICT patients and 33.3% of CRT patients, and surgical complications were reported in 31.1% and 35.9%, respectively. These findings indicate that ICT is a safe and effective neoadjuvant strategy for resectable ESCC with a more favorable safety profile.
Authors
- Qingfeng Zheng
- Derong Zhang (ORCID: https://orcid.org/0000-0002-2479-0591)
- Feng Wang (ORCID: https://orcid.org/0000-0003-4548-2309)
- Juhui Chen (ORCID: https://orcid.org/0000-0001-5037-5626)
- Peng Chen (ORCID: https://orcid.org/0000-0003-3730-1846)
- Changhong Lian (ORCID: https://orcid.org/0000-0003-3215-8673)
- Shujun Liang (ORCID: https://orcid.org/0000-0002-9567-0407)
- Mengxia Lei
- Mingqiu Chen (ORCID: https://orcid.org/0000-0001-7928-172X)
- Canhua Huang (ORCID: https://orcid.org/0000-0003-2247-7750)
- Ni Guan
- Xiaofeng Chen (ORCID: https://orcid.org/0000-0003-1333-6649)
- Yujie Chen (ORCID: https://orcid.org/0000-0002-6285-4074)
- Weijie Chen (ORCID: https://orcid.org/0000-0002-9780-1167)
- Junhua Liu (ORCID: https://orcid.org/0000-0002-7890-606X)
- Jiancheng Li (ORCID: https://orcid.org/0000-0003-2148-9872)
- Junqiang Chen (ORCID: https://orcid.org/0000-0001-7022-3099)
- Hao He (ORCID: https://orcid.org/0000-0001-7029-6992)
- Shuoyan Liu (ORCID: https://orcid.org/0000-0003-3749-1256)
- Peiyuan Wang (ORCID: https://orcid.org/0000-0003-1700-1061)
- Hui Lin (ORCID: https://orcid.org/0000-0002-8689-5006)
- Yu Lin
- Wenshan Zhang (ORCID: https://orcid.org/0009-0006-8244-3148)
- Buhong Zheng (ORCID: https://orcid.org/0000-0003-2886-2270)
- Feng-Nian Zhuang
- Rongfang Huang
- Yuanji Xu
- Huaxin Cai
- Jin Yan
- Jun-Peng Lin
- Wenwei Wei
- Jiezhong Wang
- Hang Zhou (ORCID: https://orcid.org/0000-0003-0158-2244)
Institutions
- Fujian Medical University (CN)
- Changzhi Medical College (CN)
- Zhangzhou Municipal Hospital of Fujian Province (CN)
- Zhuhai People's Hospital (CN)
- The 180th Hospital of PLA (CN)
- Jiangsu Hengrui Medicine (China) (CN)
- Fujian Provincial Cancer Hospital (CN)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-11-03
- DOI
- https://doi.org/10.1038/s41467-025-64660-z
- Citations
- 3
- Primary Topic
- Esophageal Cancer Research and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 6.02
Funders
- National Natural Science Foundation of China