The efficacy and safety of nanoparticle albumin bound‐paclitaxel‐based regimen as second‐ or third‐line treatment in patients with advanced esophageal squamous cell carcinoma

BACKGROUND: There are limited reports on nanoparticle albumin bound‐paclitaxel (nab‐paclitaxel) regimens as second‐ or third‐line treatments for advanced esophageal squamous cell carcinoma (ESCC). Additionally, its safety and efficacy in ESCC patients after failure of first‐line programmed cell death protein‐1 (PD‐1) blockade plus chemotherapy have not been reported. In this study, we aimed to assess the efficacy and tolerability of nab‐paclitaxel regimens as second‐ or later‐line treatment in advanced ESCC. METHODS: We retrospectively reviewed clinical data of advanced ESCC patients who participated in a randomized phase III clinical study and received serplulimab or placebo plus chemotherapy at our institution, and consecutive patients who received subsequent nab‐paclitaxel‐based regimens as second‐ or later‐line treatment were included for data collection and analysis. RESULTS: A total of 39 patients were included, 25 (64.1%) received serplulimab plus chemotherapy and 14 (35.9%) received chemotherapy alone as first‐line treatment. Treatment strategies included nab‐paclitaxel monotherapy (7/39, 17.9%), or in combination with other chemotherapy (19/39, 48.7%), with anti‐PD‐1 antibodies (12/39, 30.8%) or with nimotuzumab (1/39, 2.6%). Overall, the objective response rate (ORR) and disease control rate (DCR) were 33.3% (13/39) and 61.5% (24/39), respectively. With a median follow‐up of 9.7 months, the median progression‐free survival and median overall survival were 5.0 and 7.9 months, respectively. The most common adverse events were neuropathy peripheral (30.8%), anemia (30.8%), neutrophil count decreased (23.1%), and nausea (20.5%). CONCLUSIONS: Nab‐paclitaxel‐based regimen could be a safe and effective option as second‐ or later‐line treatment in patients with advanced ESCC, regardless of their previous exposure to PD‐1 inhibitors.