Sintilimab versus placebo in combination with chemotherapy as first line treatment for locally advanced or metastatic oesophageal squamous cell carcinoma (ORIENT-15): multicentre, randomised, double blind, phase 3 trial.

To evaluate sintilimab versus placebo in combination with chemotherapy (cisplatin plus paclitaxel or cisplatin plus 5-fluorouracil) as first line treatment of unresectable locally advanced, recurrent, or metastatic oesophageal squamous cell carcinoma. Multicentre, randomised, double blind, phase 3 trial. 66 sites in China and 13 sites outside of China between 14 December 2018 and 9 April 2021. 659 adults (aged ≥18 years) with advanced or metastatic oesophageal squamous cell carcinoma who had not received systemic treatment. Participants were randomised 1:1 to receive sintilimab or placebo (3 mg/kg in patients weighing <60 kg or 200 mg in patients weighing ≥60 kg) in combination with cisplatin 75 mg/m Overall survival in all patients and in patients with combined positive scores of ≥10 for expression of programmed cell death ligand 1. 659 patients were randomly assigned to sintilimab (n=327) or placebo (n=332) with chemotherapy. 616 of 659 patients (93%) received sintilimab or placebo in combination with cisplatin plus paclitaxel and 43 of 659 patients (7%) received sintilimab or placebo in combination with cisplatin plus 5-fluorouracil. At the interim analysis, sintilimab with chemotherapy showed better overall survival compared with placebo and chemotherapy in all patients (median 16.7 Compared with placebo, sintilimab in combination with cisplatin plus paclitaxel showed significant benefits in overall survival and progression free survival as first line treatment in patients with advanced or metastatic oesophageal squamous cell carcinoma. Similar benefits of sintilimab with cisplatin plus 5-fluorouracil seem promising. ClinicalTrials.gov NCT03748134.

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Déclaration de conflit d'intérêts

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from Innovent Biologics and Eli Lilly for the submitted work; LS reports receiving research funding from Innovent Biologics, Beijing Xiantong Biomedical Technology, Qilu Pharmaceutical, ZaiLab Pharmaceutical, Beihai Kangcheng (Beijing) Medical Technology, and Jacobio Pharmaceuticals; consultant fees from MSD, Merck, Mingji Biopharmaceutical, Haichuang Pharmaceutical, Herbour Biomed, and BI; honoraria from Hutchison Whampoa, Hengrui, ZaiLab, and CSTONE pharmaceutical; and serving as a consultant for Rongchang Pharmaceutical, ZaiLab, CSTONE Pharmaceutical, and BMS. AZ has participated in consulting boards, advisory boards, or both, for Amgen, Lilly, Merck, Roche, Sanofi, Servier, Baxter, MSD, Pierre Fabre, Havas Life, Alira Health, and Zymeworks.