Tislelizumab efficacy and safety compared to other anti–PD-1s: a network meta-analysis of first-line therapies for unresectable, locally advanced or metastatic esophageal squamous cell carcinoma

Journal article : Review

Introduction: The addition of programmed cell death protein-1 (PD-1) inhibitors to chemotherapy (CT) or anti-CTLA4 (ipilimumab) has recently emerged as an effective first-line (1L) treatment for esophageal squamous cell carcinoma (ESCC), the most common form of esophageal cancer globally. Methods: A systematic literature review (SLR) was conducted to identify randomized controlled trials (RCTs) investigating 1L PD-1 inhibitor regimens in adult patients with unresectable, locally advanced, or metastatic ESCC. Bayesian NMAs were conducted to evaluate overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade ≥3 treatment-related adverse events (TRAEs). Results: Three eligible RCTs were identified, evaluating three PD-1 inhibitor regimens with broad regulatory approval for 1L ESCC in combination with CT (tislelizumab, nivolumab, and pembrolizumab). Tislelizumab + CT demonstrated similar long-term OS to nivolumab + CT and pembrolizumab + CT but a significant PFS benefit over nivolumab + CT and comparable efficacy to pembrolizumab + CT. Subgroup analyses were consistent with the base case, including among patients with varying PD-L1 expression (≥1% and ≥5% Tumor Area Positivity [TAP] score or ≥1 and ≥5 combined positive score [CPS]), Asia versus the rest of world, and different underlying CT backbones. Safety profiles were comparable across the three treatments. Conclusion: Tislelizumab + CT is an effective 1L treatment option for advanced or metastatic ESCC, demonstrating comparable efficacy and safety outcomes relative to existing treatments.

Authors: Ajani, JA; Smyth, E; Tougeron, D; Jung, HA; Tang, W

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Frontiers Media
• Journal: Frontiers in Immunology
• Volume: 16
• Article number: 1657085
• Publication date: 2026-01-06
• Acceptance date: 2025-11-30
• DOI: 10.3389/fimmu.2025.1657085
• EISSN: 1664-3224
• ISSN: 1664-3224
• Language: English
• Keywords: systematic literature review; tislelizumab; immunotherapies; network meta-analysis; indirect treatment comparison; esophageal squamous cell carcinoma
• Subtype: Review