| Eligibility |
Inclusion Criteria:
- The subjects voluntarily joined the study, signed the informed consent form, and had
good compliance;
- 18-75 years;
- ECOG 0-1;
- life expectancy of at least 3 months;
- For patients diagnosed with thoracic esophageal squamous cell carcinoma by
histopathological examination of the primary tumor, the stage of esophageal cancer was
clearly diagnosed as cT1b-cT2 N+ or cT3-cT4a anyN stage by CT or MRI or color Doppler
ultrasound or PET-CT or ultrasonography before surgery , and evaluated by the
investigator as suitable for patients treated with this study protocol.
- Not received any anti-tumor therapy in the past, including but not limited to surgery,
radiotherapy, chemotherapy, immunotherapy, targeted therapy, etc. However, exploratory
thoracotomy, mediastinoscopy, excisional biopsy or similar surgical procedures for
definite diagnosis, staging and surgical treatment of esophageal cancer can be
accepted.
- Satisfactory main organ function,laboratory test must meet the following criteria:
hemoglobin (HGB) =90g/L, neutrophil count(ANC) =1.5×109/L, platelet count(PLT)
=80×109/L, Serum creatinine(CR)=1.5 upper normal limitation (UNL),total bilirubin
(TBil) =1.5 upper normal limitation (UNL), alanine aminotransferase (ALT) and
aspartate aminotransferase (AST) =2.5 UNL (For patients with liver metastasis, the
AST/ALT must be =5.0 UNL), Activated partial thromboplastin time (APTT), international
normalized ratio (INR), prothrombin time (PT) = 1.5×ULN; left ventricular ejection
fraction (LVEF) = 50%; thyroid stimulating hormone (TSH) within the normal range
Within: if the baseline TSH exceeds the normal range, subjects with total T3 (or FT3)
and FT4 within the normal range can also be enrolled;
- The doctor's clinical judgment has sufficient organ function;
- Subjects of childbearing potential must use an appropriate method of contraception
during the study period and within 120 days after the end of the study, have a
negative serum pregnancy test within 7 days prior to study enrollment, and must be
non-lactating subjects ;
Exclusion Criteria:
- Suffered from other malignant tumors within 5 years before the start of treatment in
this study;
- Patients with tumor invading the cervical esophagus or high upper thoracic segment
requiring a laryngectomy;
- Patients with a high risk of bleeding or perforation due to the obvious invasion of
the tumor into the adjacent organs (aorta or trachea) of the esophageal lesion, or
patients who have already formed a fistula;
- Subjects with any severe and/or uncontrolled disease;
- Poor blood pressure control (systolic blood pressure = 140mmHg or diastolic blood
pressure = 90mmHg);
- Subjects with any severe and/or uncontrolled disease ;
- Have clinical symptoms or diseases of the heart that are not well controlled;
- Patients with past and current objective evidence of history of pulmonary fibrosis,
interstitial pneumonia, pneumoconiosis, radiation pneumonitis, drug-related pneumonia,
severely impaired lung function;
- Acute or chronic active hepatitis B (hepatitis B surface antigen (HBsAg) or hepatitis
B core antibody (HBcAb) positive patients need to be tested for hepatitis B virus
(HBV) DNA, such as HBV DNA copy number =2×103 copies/ml or =200 IU/ml or below the
lower limit of detection, can be enrolled. HBsAg (+) subjects should receive anti-HBV
therapy throughout the study drug treatment period to avoid viral activation. For
anti-HBV Subjects with HBc(+), HBsAg(-), anti-HBs(-) and HBV viral load(-) do not need
to receive preventive anti-HBV treatment, but need to be closely monitored for virus
reactivation;
- A history of immunodeficiency, including HIV positive or other acquired or congenital
immunodeficiency diseases, or a history of organ transplantation;
- Poor control of diabetes (fasting blood glucose [FBG]> 10mmol/L);
- Clinically active diverticulitis, abdominal abscess, gastrointestinal obstruction;
- Those who have received major surgical treatment, incision biopsy or obvious traumatic
injury within 28 days before the start of study treatment; or have long-term unhealed
wounds or fractures;
- Serious arterial/venous thrombotic events, such as cerebrovascular accident (including
temporary ischemic attack, cerebral hemorrhage, cerebral infarction), deep venous
thrombosis and pulmonary embolism, occurred within 6 months before the start of study
treatment;
- Those who have a history of psychotropic substance abuse and cannot quit or have
mental disorders;
- Patients who have received tumor treatment in the past;
- Subjects with uncontrolled pleural effusion, pericardial effusion or ascites (judgment
by the investigator) who still need repeated drainage;
- Subjects with known central nervous system metastases and/or cancerous meningitis;
- History of vaccination with live attenuated vaccine within 14 days before the start of
study treatment or planned vaccination with live attenuated vaccine during the study
period;
- Active autoimmune disease requiring systemic treatment (such as the use of
disease-modifying drugs, corticosteroids or immunosuppressants) within 2 years before
the start of study treatment, alternative therapy (such as thyroxine, insulin, or
adrenal or pituitary use) Physiological corticosteroids with insufficiency, etc.) are
excluded;
- Diagnosed with immunodeficiency or receiving systemic glucocorticoid therapy or any
other form of immunosuppressive therapy. (dose>10mg/day prednisone or other equivalent
therapeutic hormones), and continued use within 2 weeks of the first administration;
- Those with a history of active tuberculosis;
- Within 4 weeks before the start of the study, are participating in or have
participated in other clinical investigators;
- Those who have been treated with other PD-1/PD-L1 inhibitors in the past cannot be
enrolled; the subjects are known to be allergic to macromolecular protein
preparations, or known to be allergic to the applied drug components;
- Those who are known to be allergic to the active ingredients or excipients of the
study drugs such as envolimab, nab-paclitaxel, and nedaplatin;
- According to the judgment of the investigator, there are concomitant diseases that
seriously endanger the safety of the subjects or affect the completion of the study,
or subjects who are considered unsuitable for enrollment for other reasons.
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