Esophageal Squamous Cell CarcinomaTME-ESCCNCT07482774
Tumor Microenvironment Changes After Neoadjuvant Chemo-Immunotherapy in Esophageal Squamous Cell Carcinoma
An observational study of Esophageal Squamous Cell Carcinoma, run by Nanjing Medical University.
Trial summary
This prospective observational study aims to characterize dynamic changes in the tumor microenvironment of patients with esophageal squamous cell carcinoma receiving standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Esophageal Squamous Cell Carcinoma
- What is being tested?
- Biological: Tumor Tissue and Blood Sample Collection
- How many people
- 12 participants
- Where
- No sites listed yet
- Study dates
- 1 Jun 2026to 31 Dec 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: This study will enroll adults with pathologically confirmed, potentially resectable esophageal squamous cell carcinoma who are scheduled to receive standard neoadjuvant chemotherapy combined with immunotherapy followed by surgery. Participants will be recruited from routine clinical practice at a single center. Tumor tissue will be collected before treatment and again at the time of surgical resection, and peripheral blood samples may also be collected when feasible for translational analyses of tumor microenvironment changes associated with pathological response and clinical outcomes.
Who may be able to join
- Age 18 to 80 years; Pathologically confirmed esophageal squamous cell carcinoma; Potentially resectable disease and planned to receive standard neoadjuvant chemotherapy combined with immunotherapy followed by surgery; ECOG performance status 0 to 2; Adequate major organ function as judged by the investigator; Willing to provide tumor tissue samples at baseline and at the time of surgery; peripheral blood samples may also be collected when feasible; Written informed consent provided;
Who cannot join
- Prior treatment with immune checkpoint inhibitors; Active infection, immunodeficiency, or autoimmune disease requiring systemic immunosuppressive therapy; Pregnancy or breastfeeding; Contraindications to study-related tissue sampling or planned surgery; Inability to comply with study procedures or follow-up;
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Dynamic Characterization of Tumor Microenvironment Remodeling and Immune Escape After Neoadjuvant Chemo-Immunotherapy in Esophageal Squamous Cell Carcinoma Using Single-Cell and Spatial Transcriptomics
This prospective observational study aims to characterize dynamic changes in the tumor microenvironment of patients with esophageal squamous cell carcinoma receiving standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Paired tumor tissue samples will be collected before treatment and at surgery, and peripheral blood samples may also be collected when feasible. Single-cell RNA sequencing and spatial transcriptomics will be used to evaluate changes in cellular composition, transcriptional states, and spatial organization within the tumor microenvironment and to explore their associations with pathological response.
Read the detailed description
Esophageal squamous cell carcinoma (ESCC) is one of the most common malignancies of the digestive tract and remains associated with poor prognosis, particularly in patients with locally advanced disease. In recent years, neoadjuvant chemotherapy combined with immune checkpoint inhibitors has emerged as a promising treatment strategy and has been increasingly adopted in clinical practice. Although encouraging pathological response rates have been reported, a substantial proportion of patients do not derive durable benefit from this treatment approach.
The tumor microenvironment plays a critical role in shaping antitumor immune responses and may influence the efficacy of immunotherapy. However, the dynamic remodeling of the tumor microenvironment during neoadjuvant chemo-immunotherapy in ESCC remains incompletely understood. In particular, changes in cellular composition, transcriptional states of immune and stromal cells, and spatial interactions among different cell populations may contribute to treatment sensitivity or resistance.
This prospective observational cohort study aims to investigate dynamic changes in the tumor microenvironment of ESCC patients treated with standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Patients with pathologically confirmed ESCC who are scheduled to receive standard neoadjuvant chemo-immunotherapy and subsequent surgery will be enrolled. Tumor tissue samples will be collected at baseline prior to treatment and again at the time of surgical resection. Peripheral blood samples may also be collected at selected time points when feasible.
Single-cell RNA sequencing will be used to characterize the cellular heterogeneity and transcriptional states of tumor, immune, and stromal cells within the tumor microenvironment. Spatial transcriptomics will be used to evaluate the spatial organization and interactions among different cell populations within tumor tissues.
The study will compare molecular and cellular features between patients who achieve pathological complete response or major pathological response and those who do not achieve significant pathological response. These analyses are intended to identify potential mechanisms of immune escape and to explore biomarkers associated with response to neoadjuvant chemo-immunotherapy.
Exploratory analyses may also evaluate associations between tumor microenvironment features and clinical outcomes, including event-free survival. The results of this study may improve understanding of the biological mechanisms underlying response and resistance to neoadjuvant chemo-immunotherapy in ESCC and may provide a basis for future translational and therapeutic studies.
- Conditions
- Esophageal Squamous Cell Carcinoma
- Being tested
- Biological: Tumor Tissue and Blood Sample Collection
- Keywords
- Tumor Microenvironment, Neoadjuvant Chemoimmunotherapy, Single-Cell RNA Sequencing, Spatial Transcriptomics, Pathological Response, Immune Escape
- Medical subject headings
- Esophageal Squamous Cell Carcinoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Biological: Tumor Tissue and Blood Sample CollectionOther
Also called Biospecimen Collection
Tumor tissue samples will be collected at baseline before treatment and again at the time of surgical resection. Peripheral blood samples may also be collected when feasible. Collected biospecimens will be used for single-cell RNA sequencing, spatial transcriptomics, and related molecular analyses to evaluate dynamic changes in the tumor microenvironment associated with treatment response.
| Study group | Role | What they receive |
|---|---|---|
| ESCC Patients Receiving Neoadjuvant Chemo-Immunotherapy | Patients with pathologically confirmed esophageal squamous cell carcinoma who are scheduled to receive standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Tumor tissue samples will be collected before treatment and at the time of surgery for translational analyses of tumor microenvironment changes associated with treatment response. Receives: Other: Biological: Tumor Tissue and Blood Sample Collection |
What is being measured
The primary outcome is the main question the study is designed to answer.
Major Pathological Response Rate
Major pathological response rate, defined as the proportion of participants with 10 percent or less residual viable tumor in the resected primary tumor specimen after neoadjuvant chemo-immunotherapy.
Measured: At surgery
Secondary outcomes (5)
Pathological Complete Response Rate
Pathological complete response rate, defined as the proportion of participants with no residual viable tumor identified in the resected primary tumor specimen and sampled regional lymph nodes after neoadjuvant chemo-immunotherapy.
Measured: At surgery
Event-Free Survival
Event-free survival, defined as the time from treatment initiation to disease progression preventing surgery, postoperative recurrence, or death from any cause.
Measured: Up to 36 months
Change in Proportion of CD8-positive T Cells in Tumor Tissue
Change in the proportion of CD8-positive T cells among total cells in paired tumor tissue samples collected before treatment and at the time of surgical resection, assessed by single-cell RNA sequencing.
Measured: Baseline (before treatment) and at surgery
Change in T-cell Exhaustion Signature Score
Change in the predefined T-cell exhaustion gene signature score in paired tumor tissue samples collected before treatment and at the time of surgical resection, assessed by single-cell RNA sequencing.
Measured: Baseline (before treatment) and at surgery
Change in Spatial Immune Cell Proximity Score
Change in a predefined spatial immune cell proximity score in paired tumor tissue samples collected before treatment and at the time of surgical resection, assessed by spatial transcriptomics.
Measured: Baseline (before treatment) and at surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Mar 2026
- Study start1 Jun 2026 (estimated)
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Esophageal Squamous Cell CarcinomaStudies of the same condition, open and under way.
- More trials run by Nanjing Medical UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 12 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Nanjing Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Zhiyun Xu, Nanjing Medical University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07482774
- Sponsor's protocol ID
- KY-2025-256-01
- Acronym
- TME-ESCC
- Status last verified
- Mar 2026
- First submitted
- 10 Mar 2026
- Last updated
- 19 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared. This is a single-center exploratory study with a small sample size, and no formal external data-sharing plan has been established at the time of registration.
Publications
Stahl PL, Salmen F, Vickovic S, Lundmark A, Navarro JF, Magnusson J, Giacomello S, Asp M, Westholm JO, Huss M, Mollbrink A, Linnarsson S, Codeluppi S, Borg A, Ponten F, Costea PI, Sahlen P, Mulder J, Bergmann O, Lundeberg J, Frisen J. Visualization and analysis of gene expression in tissue sections by spatial transcriptomics. Science. 2016 Jul 1;353(6294):78-82. doi: 10.1126/science.aaf2403.
PubMed 27365449Yang W, Xing X, Yeung SJ, Wang S, Chen W, Bao Y, Wang F, Feng S, Peng F, Wang X, Chen S, He M, Zhang N, Wang H, Zeng B, Liu Z, Kidane B, Seder CW, Koyanagi K, Shargall Y, Luo H, Peng S, Cheng C. Neoadjuvant programmed cell death 1 blockade combined with chemotherapy for resectable esophageal squamous cell carcinoma. J Immunother Cancer. 2022 Jan;10(1):e003497. doi: 10.1136/jitc-2021-003497.
PubMed 35022193Luo H, Lu J, Bai Y, Mao T, Wang J, Fan Q, Zhang Y, Zhao K, Chen Z, Gao S, Li J, Fu Z, Gu K, Liu Z, Wu L, Zhang X, Feng J, Niu Z, Ba Y, Zhang H, Liu Y, Zhang L, Min X, Huang J, Cheng Y, Wang D, Shen Y, Yang Q, Zou J, Xu RH; ESCORT-1st Investigators. Effect of Camrelizumab vs Placebo Added to Chemotherapy on Survival and Progression-Free Survival in Patients With Advanced or Metastatic Esophageal Squamous Cell Carcinoma: The ESCORT-1st Randomized Clinical Trial. JAMA. 2021 Sep 14;326(10):916-925. doi: 10.1001/jama.2021.12836.
PubMed 34519801Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
PubMed 33538338
Study at a glance
From the registry record, last updated by the sponsor on 19 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Dynamic Characterization of Tumor Microenvironment Remodeling and Immune Escape After Neoadjuvant Chemo-Immunotherapy in Esophageal Squamous Cell Carcinoma Using Single-Cell and Spatial Transcriptomics
- ClinicalTrials.gov ID
- NCT07482774
- Acronym / sponsor ID
- TME-ESCC / KY-2025-256-01
- Conditions
- Esophageal Squamous Cell Carcinoma
- Keywords
- Tumor Microenvironment, Neoadjuvant Chemoimmunotherapy, Single-Cell RNA Sequencing, Spatial Transcriptomics, Pathological Response, Immune Escape
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 12 participants (estimated)
- Lead sponsor
- Nanjing Medical UniversityUniversity, hospital or other
- Study start
- 1 Jun 2026 (estimated)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 19 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This prospective observational study aims to characterize dynamic changes in the tumor microenvironment of patients with esophageal squamous cell carcinoma receiving standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Paired tumor tissue samples will be collected before treatment and at surgery, and peripheral blood samples may also be collected when feasible. Single-cell RNA sequencing and spatial transcriptomics will be used to evaluate changes in cellular composition, transcriptional states, and spatial organization within the tumor microenvironment and to explore their associations with pathological response.
Detailed description
Esophageal squamous cell carcinoma (ESCC) is one of the most common malignancies of the digestive tract and remains associated with poor prognosis, particularly in patients with locally advanced disease. In recent years, neoadjuvant chemotherapy combined with immune checkpoint inhibitors has emerged as a promising treatment strategy and has been increasingly adopted in clinical practice. Although encouraging pathological response rates have been reported, a substantial proportion of patients do not derive durable benefit from this treatment approach.
The tumor microenvironment plays a critical role in shaping antitumor immune responses and may influence the efficacy of immunotherapy. However, the dynamic remodeling of the tumor microenvironment during neoadjuvant chemo-immunotherapy in ESCC remains incompletely understood. In particular, changes in cellular composition, transcriptional states of immune and stromal cells, and spatial interactions among different cell populations may contribute to treatment sensitivity or resistance.
This prospective observational cohort study aims to investigate dynamic changes in the tumor microenvironment of ESCC patients treated with standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Patients with pathologically confirmed ESCC who are scheduled to receive standard neoadjuvant chemo-immunotherapy and subsequent surgery will be enrolled. Tumor tissue samples will be collected at baseline prior to treatment and again at the time of surgical resection. Peripheral blood samples may also be collected at selected time points when feasible.
Single-cell RNA sequencing will be used to characterize the cellular heterogeneity and transcriptional states of tumor, immune, and stromal cells within the tumor microenvironment. Spatial transcriptomics will be used to evaluate the spatial organization and interactions among different cell populations within tumor tissues.
The study will compare molecular and cellular features between patients who achieve pathological complete response or major pathological response and those who do not achieve significant pathological response. These analyses are intended to identify potential mechanisms of immune escape and to explore biomarkers associated with response to neoadjuvant chemo-immunotherapy.
Exploratory analyses may also evaluate associations between tumor microenvironment features and clinical outcomes, including event-free survival. The results of this study may improve understanding of the biological mechanisms underlying response and resistance to neoadjuvant chemo-immunotherapy in ESCC and may provide a basis for future translational and therapeutic studies.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| ESCC Patients Receiving Neoadjuvant Chemo-Immunotherapy | – | Other: Biological: Tumor Tissue and Blood Sample CollectionPatients with pathologically confirmed esophageal squamous cell carcinoma who are scheduled to receive standard neoadjuvant chemotherapy combined with immunotherapy followed by surgical resection. Tumor tissue samples will be collected before treatment and at the time of surgery for translational analyses of tumor microenvironment changes associated with treatment response. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- This study will enroll adults with pathologically confirmed, potentially resectable esophageal squamous cell carcinoma who are scheduled to receive standard neoadjuvant chemotherapy combined with immunotherapy followed by surgery. Participants will be recruited from routine clinical practice at a single center. Tumor tissue will be collected before treatment and again at the time of surgical resection, and peripheral blood samples may also be collected when feasible for translational analyses of tumor microenvironment changes associated with pathological response and clinical outcomes.
Key inclusion criteria (1 listed)
- Age 18 to 80 years; Pathologically confirmed esophageal squamous cell carcinoma; Potentially resectable disease and planned to receive standard neoadjuvant chemotherapy combined with immunotherapy followed by surgery; ECOG performance status 0 to 2; Adequate major organ function as judged by the investigator; Willing to provide tumor tissue samples at baseline and at the time of surgery; peripheral blood samples may also be collected when feasible; Written informed consent provided;
Key exclusion criteria (1 listed)
- Prior treatment with immune checkpoint inhibitors; Active infection, immunodeficiency, or autoimmune disease requiring systemic immunosuppressive therapy; Pregnancy or breastfeeding; Contraindications to study-related tissue sampling or planned surgery; Inability to comply with study procedures or follow-up;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Biological: Tumor Tissue and Blood Sample CollectionAlso: Biospecimen CollectionTumor tissue samples will be collected at baseline before treatment and again at the time of surgical resection. Peripheral blood samples may also be collected when feasible. Collected biospecimens will be used for single-cell RNA sequencing, spatial transcriptomics, and related molecular analyses to evaluate dynamic changes in the tumor microenvironment associated with treatment response. | Other | ESCC Patients Receiving Neoadjuvant Chemo-Immunotherapy |
Primary outcome
Major Pathological Response Rate
Time frame: At surgery
Major pathological response rate, defined as the proportion of participants with 10 percent or less residual viable tumor in the resected primary tumor specimen after neoadjuvant chemo-immunotherapy.
5 secondary outcomes
Pathological Complete Response Rate
Time frame: At surgery
Event-Free Survival
Time frame: Up to 36 months
Change in Proportion of CD8-positive T Cells in Tumor Tissue
Time frame: Baseline (before treatment) and at surgery
Change in T-cell Exhaustion Signature Score
Time frame: Baseline (before treatment) and at surgery
Change in Spatial Immune Cell Proximity Score
Time frame: Baseline (before treatment) and at surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Mar 2026.
- Background: PubMed 27365449Stahl PL, Salmen F, Vickovic S, Lundmark A, Navarro JF, Magnusson J, Giacomello S, Asp M, Westholm JO, Huss M, Mollbrink A, Linnarsson S, Codeluppi S, Borg A, Ponten F, Costea PI, Sahlen P, Mulder J, Bergmann O, Lundeberg J, Frisen J. Visualization and analysis of gene expression in tissue sections by spatial transcriptomics. Science. 2016 Jul 1;353(6294):78-82. doi: 10.1126/science.aaf2403.
- Background: PubMed 35022193Yang W, Xing X, Yeung SJ, Wang S, Chen W, Bao Y, Wang F, Feng S, Peng F, Wang X, Chen S, He M, Zhang N, Wang H, Zeng B, Liu Z, Kidane B, Seder CW, Koyanagi K, Shargall Y, Luo H, Peng S, Cheng C. Neoadjuvant programmed cell death 1 blockade combined with chemotherapy for resectable esophageal squamous cell carcinoma. J Immunother Cancer. 2022 Jan;10(1):e003497. doi: 10.1136/jitc-2021-003497.
- Background: PubMed 34519801Luo H, Lu J, Bai Y, Mao T, Wang J, Fan Q, Zhang Y, Zhao K, Chen Z, Gao S, Li J, Fu Z, Gu K, Liu Z, Wu L, Zhang X, Feng J, Niu Z, Ba Y, Zhang H, Liu Y, Zhang L, Min X, Huang J, Cheng Y, Wang D, Shen Y, Yang Q, Zou J, Xu RH; ESCORT-1st Investigators. Effect of Camrelizumab vs Placebo Added to Chemotherapy on Survival and Progression-Free Survival in Patients With Advanced or Metastatic Esophageal Squamous Cell Carcinoma: The ESCORT-1st Randomized Clinical Trial. JAMA. 2021 Sep 14;326(10):916-925. doi: 10.1001/jama.2021.12836.
- Background: PubMed 33538338Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
- Individual participant dataSharing planned: No. Individual participant data will not be shared. This is a single-center exploratory study with a small sample size, and no formal external data-sharing plan has been established at the time of registration.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
An observational study of Esophageal Squamous Cell Carcinoma, run by Nanjing Medical University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 19 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Zhiyun Xu, M.D. (+86 15251759696, zhiyunxu2012@njmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Major Pathological Response Rate (time frame: At surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07482774, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Mar 2026; AzTrials last refreshed its copy on 1 Nov 2026.