Dose dependent nanoparticle albumin bound paclitaxel + pembrolizumab alters the immune micro environment in a esophageal homograft mouse model.

Esophageal cancer has remained a therapeutic challenge despite the advancements in targeted therapy and immunotherapy. This study investigated the mechanism by which neoadjuvant pembrolizumab combined with carboplatin and varying dosages of albumin-bound paclitaxel (ABP) regulates immune microenvironment in esophageal cancer. In vivo, a homograft mouse model was constructed. Both combined treatment groups displayed considerably decreased tumor volume (P < 0.001). Furthermore, the combined treatment inhibited tumor progression by downregulating SHC adaptor protein 4 (shc4) expression, and modulating immune cell homeostasis, as evidenced by remarkably reduced T helper Th1/Th2 and Th17/Regulatory T (Treg) ratios (P < 0.05). Cytokine analysis data revealed that levels of neutrophil cytosolic factor 2 (Ncf2) and related factors were higher in the two combined treatment groups than the Model group (P < 0.05). This study demonstrates that neoadjuvant combination therapy inhibits esophageal cancer progression by reshaping the immune landscape.