ORIGINAL RESEARCH article
Front. Cell Dev. Biol.
Sec. Cancer Cell Biology
This article is part of the Research TopicAdvancements in Solid Tumor Immunotherapy: Enhancing Efficacy and Overcoming ResistanceView all 14 articles
Effectiveness Comparison of Domestic versus Imported Immune Checkpoint Inhibitors in Neoadjuvant Chemoimmunotherapy for Esophageal Squamous Cell Carcinoma
Provisionally accepted
- Fujian Medical University Union Hospital, Fuzhou, China
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Background and Purpose: Neoadjuvant chemoimmunotherapy (nICT) has emerged as a promising strategy for esophageal squamous cell carcinoma (ESCC). However, the efficacy and safety comparison of imported and domestic immune drugs remain unclear. This study aimed to compare short-and long-term efficacy between domestic and imported immunotherapeutic agents. Method: A total of 128 ESCC patients were retrospectively analyzed. Domestic immune drugs included sintilimab, tislelizumab, camrelizumab, and toripalimab, while the imported drug was pembrolizumab. Propensity score matching (PSM) was applied to balance baseline characteristics. Cox analysis, Kaplan-Meier survival and landmark analysis were used for survival analysis. Study outcomes included recurrence-free survival (RFS), locoregional recurrence-free survival (L-RFS), distant metastasis-free survival (D-MFS), pathological response, and postoperative complications. Result: 97 patients received domestic drugs and 31 received imported drugs. No significant differences were observed in RFS (p = 0.351), L-RFS (p = 0.075) and D-MFS (p = 0.772) before PSM. After PSM, survival outcomes remained comparable. 12th-month landmark analysis also showed no significant differences between two cat. Although imported drugs were associated with a higher MPR rate before matching (p = 0.005), this difference was not significant after PSM (p = 0.128). Complication rates were similar except for fewer pleural effusions (p = 0.026) and more electrolyte disturbances (p = 0.030) in the imported group after PSM. Conclusion: Domestic and imported immune drugs demonstrated comparable long-term survival and safety in ESCC patients receiving nICT. Although imported agents may offer a modest advantage in pathological response, both categories remain effective options for clinical use.
Keywords: Domestic immune drugs, imported immune drugs, Landmark analysis, neoadjuvant chemoimmunotherapy, survival analysis
Received: 11 Nov 2025; Accepted: 05 Jan 2026.
Copyright: © 2026 Chen, Xie, Hong and Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhinuan Hong
Mingqiang Kang
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