Phase 2 toripalimab induction and post-chemoradiation treatment targets locally advanced esophageal squamous cancer

Vanderbilt-Ingram Cancer Center is running this Phase 2 window-of-opportunity study in treatment-naive, resectable stage II-IVA esophageal squamous cell carcinoma. Participants receive induction toripalimab, a PD-1-blocking antibody, followed by carboplatin/paclitaxel chemoradiation and then protocol-directed adjuvant toripalimab for up to 1 year. Toripalimab is not administered concurrently with the chemoradiation portion. Subsequent management can include surgery before adjuvant treatment, according to the protocol and clinical assessment.

The study assesses clinical complete response and safety, with tumor and adjacent-tissue biopsies, blood including circulating tumor DNA, and saliva collected to characterize the effects of induction PD-1 blockade. The clinical question is whether immunotherapy before and after chemoradiation improves disease control and helps clarify response biology. Standard treatment decisions for locally advanced esophageal squamous cancer already involve multidisciplinary selection of chemoradiation and, for appropriate resectable disease, surgery; this sequencing approach remains investigational.