SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1607715
Application of chemotherapy combined with immunotherapy in first-line treatment of advanced esophageal cancer: Fluorouracil or paclitaxel? -- A meta-analysis
Provisionally accepted
- Zhejiang Provincial People's Hospital, Hangzhou, China
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Immunotherapy combined with chemotherapy is now the first-line standard for metastatic/recurrent esophageal cancer, with rapid immunotherapy advancements significantly improving patient outcomes. International guidelines recommend platinum-based combinations with either 5-fluorouracil or paclitaxel as first-line treatments. Currently, no head-to-head studies directly compare fluorouracil and paclitaxel regimens in esophageal cancer. We systematically searched online literature for clinical trials investigating first-line immunotherapy-chemotherapy combinations for esophageal cancer. Data were analyzed using Review Manager (RevMan) 5.3 software, with pooled results expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Both paclitaxel- and fluorouracil-based immunotherapy combinations demonstrated clinical benefits in overall survival, progression-free survival, and objective response rates. Notably, paclitaxel-based immunotherapy significantly increased ORR compared to fluorouracil-based regimens (OR 2.61 vs 1.58). Our findings suggest that paclitaxel-immunotherapy combinations may offer enhanced disease control compared to fluorouracil-based approaches, warranting further studies to identify optimal patient populations and refine treatment strategies.
Keywords: chemotherapy, Immunotherapy, esophageal cancer, Meta analysis； Paclitaxel, Fluorouracil
Received: 15 Apr 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Chen, Yan, Zhao and Zhu. 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: pengfei Zhu, Zhejiang Provincial People's Hospital, Hangzhou, China
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