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Introduction <p>Granulocyte-colony stimulating factor (G-CSF)-producing esophageal squamous cell carcinoma (ESCC) is a rare and highly aggressive malignancy. Currently, no specific treatment approach has been established for G-CSF-producing tumors, including those in the lungs, esophagus, and other organs. Here, we present three cases of advanced G-CSF-producing ESCC treated with immune checkpoint inhibitor (ICI) combination chemotherapy.</p> Case presentation <p>Case 1: A 52-year-old man was diagnosed with G-CSF-producing ESCC with multiple lymph node and lung metastases. First-line chemotherapy with fluorouracil (5-FU), cisplatin, and pembrolizumab (FP + PEM) led to significant tumor regression and normalization of inflammatory marker levels. The regimen was de-escalated to 5-FU and pembrolizumab, and the disease remains stable. Case 2: A 69-year-old man was diagnosed with G-CSF-producing ESCC with multiple lymph node metastases. FP + PEM therapy initially reduced the tumor burden, but disease progression occurred after four treatment cycles. The patient was switched to second-line weekly paclitaxel. Case 3: A 62-year-old man was diagnosed with G-CSF-producing ESCC with bone metastasis. FP + PEM therapy achieved partial response in the primary tumor, but bone metastasis progressed, requiring radiation and a switch to paclitaxel.</p> Conclusions <p>We report three cases of advanced G-CSF-producing ESCC treated with ICI combination chemotherapy. Although ICIs show promise, treatment resistance remains a challenge. Further research and additional case accumulation are needed to better understand their efficacy and optimize treatment strategies.</p>

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Immune checkpoint inhibitor-based chemotherapy for granulocyte-colony stimulating factor-producing advanced esophageal squamous cell carcinoma: a report of three cases

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Kohei Suto,
  • Akiharu Kimura,
  • Etsuko Hisanaga,
  • Takahiro Shirakura,
  • Tatsuro Maehara,
  • Makoto Sakai,
  • Akihiko Sano,
  • Nobuhiro Nakazawa,
  • Ken Shirabe,
  • Hiroshi Saeki

摘要

Introduction

Granulocyte-colony stimulating factor (G-CSF)-producing esophageal squamous cell carcinoma (ESCC) is a rare and highly aggressive malignancy. Currently, no specific treatment approach has been established for G-CSF-producing tumors, including those in the lungs, esophagus, and other organs. Here, we present three cases of advanced G-CSF-producing ESCC treated with immune checkpoint inhibitor (ICI) combination chemotherapy.

Case presentation

Case 1: A 52-year-old man was diagnosed with G-CSF-producing ESCC with multiple lymph node and lung metastases. First-line chemotherapy with fluorouracil (5-FU), cisplatin, and pembrolizumab (FP + PEM) led to significant tumor regression and normalization of inflammatory marker levels. The regimen was de-escalated to 5-FU and pembrolizumab, and the disease remains stable. Case 2: A 69-year-old man was diagnosed with G-CSF-producing ESCC with multiple lymph node metastases. FP + PEM therapy initially reduced the tumor burden, but disease progression occurred after four treatment cycles. The patient was switched to second-line weekly paclitaxel. Case 3: A 62-year-old man was diagnosed with G-CSF-producing ESCC with bone metastasis. FP + PEM therapy achieved partial response in the primary tumor, but bone metastasis progressed, requiring radiation and a switch to paclitaxel.

Conclusions

We report three cases of advanced G-CSF-producing ESCC treated with ICI combination chemotherapy. Although ICIs show promise, treatment resistance remains a challenge. Further research and additional case accumulation are needed to better understand their efficacy and optimize treatment strategies.