A cancer immunotherapy drug from China’s BeiGene, previously used in inoperable esophageal cancer, may also change how some operable esophagus tumors are treated, according to findings from a phase 2 trial.
In the study, patients with newly diagnosed esophageal cancer that had extended beyond its original location received standard preoperative chemoradiation. Investigators then evaluated whether a second course of treatment—including BeiGene’s PD-1 inhibitor, Tevimbra (tislelizumab)—administered before surgery could improve outcomes. The results will be presented at the American Society of Clinical Oncology (ASCO) 2025 Annual Meeting.
The trial enrolled 87 patients whose tumors were no longer visible on imaging following chemoradiation with paclitaxel, carboplatin, and concurrent radiation therapy.
Typically, these patients would proceed directly to surgery to remove part or all of the esophagus, after which pathologists assess the excised tissue for residual cancer cells. According to the study investigators, residual cancer is associated with a recurrence rate exceeding 50%.
In this trial, 44 patients (50.6%) received 2 additional cycles of chemotherapy and Tevimbra before surgery, while the remaining 43 patients (49.4%) underwent surgery without further treatment.
Pathologic examination of surgical specimens showed that 40.7% of patients in the Tevimbra group achieved a pathological complete response (no residual cancer cells), compared with 18.1% in the control group. After adjusting for individual risk factors, patients who received Tevimbra were nearly 3 times more likely to achieve a complete response.
At 1 year, 95.6% of patients who received Tevimbra remained alive without disease progression (progression-free survival), compared with 77.3% in the surgery-alone group. This difference, however, did not reach statistical significance.
“This pioneering study demonstrates that sequential chemo-immunotherapy... significantly improves pathological complete response rates by more than two-fold and shows promising progression-free survival trends with manageable toxicity,” the researchers stated.
They called for larger, late-phase trials to confirm these results, which could “redefine the standard of care.”
