A Phase III, Randomized, Multicenter Study of PD-1 Antibody Combined With mXELIRI Versus mXELIRI in the Second-line Treatment of Metastatic Esophageal Squamous Cell Carcinoma
This trial is a prospective, multicenter, randomized controlled trial. The sample size was 380. Patients with advanced or metastatic esophageal squamous cell carcinoma will be randomized to receive PD1 antibody combined with mXELIRI or mXELIRI regimens in a 1:1 ratio. The stratification factors include PS status (0 vs 1), PFS of first-line treatment (PFS \< 3 months versus PFS ≥3 months) . Six cycles of chemotherapy are planned every 3 weeks, for a total of 18 weeks, after which the investigator can decide whether to provide capecitabine with or without PD1 antibody maintenance therapy. Efficacy assessments were performed every 6 weeks before disease progression during treatment. Survival status was followed every 3 months after disease progression.
• Voluntarily participate and sign the informed consent form
• Age≥ 18 years old, gender is not limited
• Estimated survival time≥ 3 months
• Physical status ECOG status score of 0 or 1
• metastatic esophageal squamous cell carcinoma, including patients with postoperative recurrence and metastasis that cannot be operated or are not suitable for radical radiotherapy, first-line chemotherapy combined with PD-1 antibody therapy is unsuccessful or intolerable (first-line chemotherapy does not use fluorouracils and irinotecan)
• If metastatic esophageal cancer has serious clinical symptoms due to lesions, palliative radiotherapy is required first, and radiotherapy is required to be completed for more than 4 weeks (radiotherapy lesions include but are not limited to primary lesions, bones, and lymph nodes)
• Bone marrow hematopoietic function: hemoglobin ≥ 9.0g/dL, white blood cell ≥ 4.0×109/L, neutrophil ≥ 1.5×109/L, platelet ≥ 90×109/L
• Liver and kidney function: total bilirubin ≤ 1.5 × ULN, creatinine ≤ 1.0 × ULN, AST/ALT ≤ 2.5 ULN, ALP 5.0 ULN, creatinine clearance ≥ 60mL/min, subjects with liver metastases: AST/ALT ≤5.0 ULN
• Female subject must have taken reliable contraceptive measures of childbearing potential should have a negative urine or serum pregnancy within 7 days prior to receiving the first dose of study medication. and be willing to use an appropriate method of contraception during the trial and 8 weeks after the last administration of the test drug. Male subject should agree to use appropriate contraceptive methods or to have been surgically sterilized during the trial and 8 weeks after the last administration of the test drug
⁃ Those who have good compliance and can follow up according to the requirements of the plan.