BRIEF RESEARCH REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicPrecision Medicine and Targeted Therapies in Gastrointestinal and Genitourinary Solid TumorsView all 29 articles
Real-World Experience with First-Line Pembrolizumab Plus Chemotherapy in Vietnamese Patients with Stage IV Esophageal Squamous Cell Carcinoma
Provisionally accepted
Thuan Van Tran1,2
Phuong Thu Nguyen2,3*Quang Van Le2,3Giang Huong T. Nguyen2
Huy Le Trinh2Kien Hoang Le4
Giap Ngoc Hoang2- 1Ministry of Health, Hanoi, Vietnam
- 2Vietnam National Cancer Hospital, Hanoi, Vietnam
- 3Department of Oncology, Hanoi Medical University, Hanoi, Vietnam
- 4Bach Mai Hospital, Hanoi, Vietnam
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: This study examined the clinical characteristics, disease course, and treatment-related toxicities of Vietnamese patients with stage IV ESCC receiving this regimen. Methods: We conducted a single-center, single-arm, retrospective analysis of 53 patients with stage IV ESCC treated with pembrolizumab plus platinum- and fluoropyrimidine-based chemotherapy. Information on demographics, clinical presentation, pathology, biomarker status, treatment regimens, patterns of progression or recurrence, and adverse events (AEs) was collected from electronic health records. Results: The mean age was 59 years, with nearly all patients being male. Most presented with advanced T3/N2 disease and dysphagia at diagnosis. PD-L1 status was unavailable in about one-third of cases. Common chemotherapy backbones were CF (50.9%) and XELOX/SOX (24.5%). Progression or recurrence was documented in 24.5% of patients, and 20.8% occurred within six months. Lymph nodes were the most frequent site of progression, followed by local and distant recurrence. Hematologic toxicities were common, including neutropenia (43.4% all grades, 13.2% grade ≥3) and anemia (50.9% all grades). Nausea (20.8%) and diarrhea (5.7%) were the main gastrointestinal toxicities. Immune-related events included hypothyroidism (3.8%) and pneumonitis (3.8%). Conclusions: In this Vietnamese cohort, pembrolizumab plus chemotherapy showed a manageable safety profile and recurrence patterns consistent with those reported internationally. These findings add region-specific real-world evidence and underline the importance of broader multi-center studies with longer follow-up to inform practice in advanced ESCC.
Keywords: esophageal squamous cell carcinoma, first-line therapy, Pembrolizumab, Real-world outcomes, Vietnam
Received: 26 Sep 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Tran, Nguyen, Le, Nguyen, Trinh, Le and Hoang. 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: Phuong Thu Nguyen
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.