Clinical role of anti-PD-1 immunotherapies in esophageal cancer.

[INTRODUCTION] Anti-PD-1 antibodies in pharmacotherapy for esophageal cancer have caused a paradigm shift in the treatment strategy. New evidence is being generated not only for metastatic or recurrent cases, but also in the perioperative setting, and the role of anti-PD-1 antibodies in the treatment of esophageal cancer will continue to increase.

[AREAS COVERED] This review summarizes the clinical role of approved anti-PD-1 antibodies, including nivolumab and pembrolizumab, and discusses additional agents supported by phase 3 evidence. We emphasize current standards of care across metastatic and perioperative settings while briefly addressing emerging strategies under clinical evaluation.

[EXPERT OPINION] Anti-PD-1 antibodies containing therapies have become central to ESCC management, improving survival in both metastatic and perioperative settings. Regional phase 3 trials have expanded therapeutic options, although differences in regulatory approval influence global accessibility. Despite these advances, optimal patient selection remains challenging, and predictive biomarkers are urgently needed. Future progress will depend on biomarker development, treatment sequencing, and integration of emerging strategies supported by robust clinical evidence.