259 Complete Pathological Response to Pembrolizumab in Locally Advanced Oesophageal Cancer: A Case Study
Bibliographic record
Abstract
Abstract Background Pembrolizumab was approved by NICE in 2021 for use with platinum- and fluoropyrimidine-based chemotherapy in patients with locally advanced unresectable, or metastatic PD-L1 expressing carcinoma of the oesophagus. We describe a case of locally advanced oesophageal adenocarcinoma in which treatment with pembrolizumab resulted in a complete pathological response. Case Presentation A 70-year-old gentleman presented with T3N2M0 moderately differentiated lower oesophageal adenocarcinoma. He underwent neoadjuvant chemotherapy with fluorouracil, oxaliplatin, and docetaxel (FLOT), resulting in a partial radiological response. Upon completion of neoadjuvant therapy, the tumour was deemed operable, however the patient initially declined surgery. Surveillance imaging at three months demonstrated disease progression. Eight cycles of carboplatin and capecitabine were then completed. Although initially radiologically stable, subsequent disease progression resulted in dysphagia. Pembrolizumab was started and continued for six months. Three months into treatment, worsening dysphagia prompted oesophageal stenting, with only temporary symptomatic relief and nasojejunal feeding was commenced. Restaging PET-CT demonstrated operable disease, with focal uptake adjacent to the primary tumour and ongoing left gastric node avidity. The patient underwent an uncomplicated robotic-assisted oesophagogastrectomy. Final histopathology revealed a complete pathological response, with no residual tumour, dysplasia, or lymph node involvement. Conclusions This case demonstrates the use of pembrolizumab in the management of patients with PD-L1 expressing oesophageal carcinoma and highlights the evolving role of immunotherapy in oesophagogastric cancer treatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".