ClinicalTrials.gg
Not yet recruitingNCT07830355Updated Sep 21, 2026

Immunotherapy Plus Anlotinib After Surgery for Esophageal Squamous Cell Cancer With Residual Tumor and Positive Lymph Nodes

A Phase 2 interventional study of Anlotinib and Anti-PD-1 Monoclonal Antibody in Esophageal Squamous Cell Carcinoma, sponsored by Shanghai Chest Hospital. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by Shanghai Chest Hospital · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
75
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The goal of this clinical trial is to learn whether postoperative immunotherapy combined with anlotinib can help prevent or delay cancer recurrence in adults aged 18 to 75 years with locally advanced esophageal squamous cell carcinoma. Eligible participants must have previously received chemotherapy combined with anti-PD-1 immunotherapy, followed by complete surgical removal of the cancer. Examination of the surgical specimens must show more than 10% viable tumor remaining in the original tumor bed and cancer cells remaining in regional lymph nodes.

The main questions this trial aims to answer are:

  • What proportion of participants are alive without cancer recurrence or a second primary cancer 12 months after enrollment?
  • How long do participants remain free of cancer recurrence, and how long do they survive?
  • What treatment-related medical problems occur during treatment with anti-PD-1 immunotherapy plus anlotinib?
  • Where does the cancer recur if recurrence occurs? All participants will receive the same study treatment; there is no comparison group.

Participants will:

  • Receive an anti-PD-1 immunotherapy medicine by intravenous infusion once every 3 weeks, generally using the same anti-PD-1 medicine received before surgery
  • Take anlotinib by mouth once daily for 14 days, followed by 7 days without anlotinib, in each 21-day treatment cycle
  • Continue treatment for up to 15 cycles unless the cancer returns, unacceptable side effects occur, consent is withdrawn, or another reason for stopping treatment arises
  • Undergo regular clinic visits, laboratory tests, physical examinations, and safety assessments during treatment
  • Undergo imaging examinations approximately every 3 months to check for cancer recurrence
  • Be followed for disease recurrence and survival for up to 5 years after surgery Stored surgical tumor tissue will also be studied to explore whether features of the tumor immune environment are associated with treatment outcomes.
02

Conditions studied

  • Esophageal Squamous Cell Carcinoma

Keywords

  • Anlotinib
  • Non-Major Pathological Response
  • ypN-Positive Disease
  • Adjuvant Therapy
  • Neoadjuvant Chemoimmunotherapy
03

In context

Esophageal Squamous Cell Carcinoma

675 studies on the registry are indexed under Esophageal Squamous Cell Carcinoma; 267 are open to participants now.

This study's planned enrollment of 75 is above the median of 64 across 563 interventional studies indexed under Esophageal Squamous Cell Carcinoma.

Browse Esophageal Squamous Cell Carcinoma studies →

Lead sponsor

Shanghai Chest Hospital is the lead sponsor of 198 studies on the registry; 98 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 18 to 75 years, inclusive.
  • (ECOG) performance status of 0 to 2.
  • confirmed locally advanced esophageal squamous cell carcinoma.
  • Prior treatment with 2 to 4 cycles of chemotherapy combined with an monoclonal antibody, followed by radical surgery with pathologically confirmed R0 resection.
  • An interval of no more than 10 weeks between completion of the last neoadjuvant chemotherapy or immunotherapy treatment and radical surgery.
  • Postoperative pathological assessment showing non-major pathological response, defined as more than 10% residual viable tumor cells in the primary tumor bed, and viable tumor in at least one resected regional lymph node (ypN-positive disease).
  • Enrollment within 10 weeks after esophagectomy.
  • Ability to swallow and tolerate oral medication, without severe dysphagia, chronic diarrhea, intestinal obstruction, or another condition that may substantially affect oral drug absorption.
  • Adequate organ function, based on laboratory tests performed within 7 days before the first dose and without blood transfusion, erythropoietin, granulocyte colony-stimulating factor, or similar supportive treatment within the preceding 14 days, meeting all of the following criteria:
  • ≥1.5 × 10\^9/L.
  • count ≥100 × 10\^9/L.
  • ≥90 g/L.
  • Total ≤1.5 × the (ULN).
  • and aspartate aminotransferase ≤2.5 × ULN.
  • Serum creatinine ≤1.5 × ULN or ≥60 mL/min.
  • Urine protein negative or 1+ on routine urinalysis. If urine protein is 2+ or higher, 24-hour urinary protein must be ≤1.0 g.
  • ≤1.5, prothrombin time no more than 4 seconds above ULN, and activated partial thromboplastin time ≤1.5 × ULN.
  • Systolic blood pressure \<140 mmHg and diastolic blood pressure \<90 mmHg, without antihypertensive medication or while receiving no more than two antihypertensive medications.
  • Thyroid-stimulating hormone within the normal range. Participants with abnormal thyroid-stimulating hormone may be eligible if free triiodothyronine and free thyroxine are within the normal ranges and the investigator determines that systemic treatment is not required and that observation, stable endocrine replacement therapy, or symptomatic treatment is sufficient.
  • Fasting blood glucose ≤10 mmol/L or ≤8%. Participants with diabetes must have stable glycemic control with medication.
  • ≥50% and resting interval \<480 milliseconds.
  • No myocardial infarction or severe or unstable angina within 6 months before the first dose; no clinically symptomatic severe arrhythmia; and no congestive heart failure of Class II or higher.
  • Ability to understand the study and voluntarily provide written .

Exclusion criteria

Exclusion Criteria:

  • Esophageal cancer with a pathological type other than squamous cell carcinoma.
  • Distant organ or distant lymph node identified by preoperative imaging, intraoperative exploration, or postoperative pathological examination, corresponding to M1 disease according to the American Joint Committee on Cancer staging system, Eighth Edition.
  • No prior therapy, or prior neoadjuvant therapy other than chemotherapy combined with immunotherapy, including neoadjuvant chemotherapy alone or neoadjuvant chemoradiotherapy.
  • Use of an antibody or another immune checkpoint inhibitor other than an anti-PD-1 antibody during neoadjuvant treatment.
  • One or fewer, or more than four, cycles of neoadjuvant chemoimmunotherapy.
  • A Grade 4 or higher immune-related adverse event, Grade 3 or higher immune-related pneumonitis, or Grade 2 or higher immune-related myocarditis during prior neoadjuvant treatment, according to the , Version 5.0.
  • Substantial extranodal extension, fixed or matted regional lymph nodes, or involvement of important surrounding tissues or organs found during surgery that, in the investigator's judgment, prevented complete oncological resection or created a clear risk of residual disease; or postoperative evidence of R1 or R2 resection.
  • Major pathological response or pathologically negative regional lymph nodes (ypN0) after neoadjuvant treatment.
  • A severe postoperative complication of Grade 3 or higher that has not recovered to Grade 1 or lower or to the preoperative baseline before planned adjuvant treatment or within 10 weeks after surgery; or a postoperative complication that, in the investigator's judgment, has substantially reduced the participant's performance status and is expected to prevent tolerance of adjuvant treatment.
  • Poor nutritional status or a Patient-Generated Subjective Global Assessment score ≥9.
  • An unhealed wound, ulcer, or fracture.
  • Any Grade 2 or higher bleeding event within 4 weeks before the first dose.
  • Evidence of a bleeding diathesis; current thrombolytic therapy or therapeutic anticoagulation; or use of an antiplatelet drug, such as clopidogrel, or high-dose aspirin >325 mg/day within 14 days before the first dose. Low-dose aspirin ≤100 mg/day for cardiovascular prevention is permitted.
  • An arterial or venous thromboembolic event within 6 months before the first dose, including cerebrovascular accident, , deep vein thrombosis, or pulmonary embolism.
  • A concurrent second primary or a history of another malignancy within the previous 5 years, except completely cured cervical carcinoma in situ, basal cell carcinoma of the skin, or squamous cell carcinoma of the skin.
  • Active disease, or a history of autoimmune disease that currently requires systemic treatment. Stable thyroid dysfunction that does not require systemic immunosuppression, including hypothyroidism controlled with hormone replacement or stably controlled hyperthyroidism, is permitted.
  • An active infection requiring systemic treatment; active tuberculosis; or a history of tuberculosis without adequate treatment and with current evidence of active disease. A participant with latent tuberculosis infection may be enrolled only after assessment by an infectious disease or respiratory specialist confirms that enrollment is safe.
  • An uncontrolled active viral or sexually transmitted infection, including surface antigen positivity with hepatitis B virus DNA above the institutional lower limit of detection when standard antiviral therapy has not been initiated or cannot be administered following specialist assessment; uncontrolled virus RNA positivity; known infection without standard antiviral treatment or with inadequate virological control; or active syphilis.
  • Known severe to an active ingredient or of either study treatment.
Terms in these criteria, in plain language(28)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
75 participants (estimated)

Study arms

  • Experimental
    Experimental Arm

    Participants will receive an anti-PD-1 monoclonal antibody by intravenous infusion on Day 1 of each 21-day cycle, generally using the same anti-PD-1 agent administered during neoadjuvant treatment. Anlotinib will be administered orally at a starting dose of 12 mg once daily on Days 1-14 of each 21-day cycle. Study treatment must begin within 10 weeks after surgery and will continue for up to 15 cycles unless disease recurrence, unacceptable toxicity, withdrawal of consent, or another protocol-defined reason for discontinuation occurs. Protocol-specified treatment interruptions and dose reductions of anlotinib to 10 mg or 8 mg are permitted for toxicity. Dose reduction of the anti-PD-1 agent is not permitted.

    Drug: Anlotinib · Drug: Anti-PD-1 Monoclonal Antibody

Interventions

  • Anlotinib will be administered orally at a starting dose of 12 mg once daily on Days 1-14 of each 21-day cycle. Treatment will begin concurrently with anti-PD-1 immunotherapy within 10 weeks after surgery and continue for up to 15 cycles unless disease recurrence, unacceptable toxicity, withdrawal of consent, or another protocol-defined discontinuation criterion occurs. Dose interruptions and reductions to 10 mg and 8 mg once daily are permitted according to protocol-defined toxicity management criteria.

  • An anti-PD-1 monoclonal antibody will be administered by intravenous infusion on Day 1 of each 21-day cycle, generally using the same anti-PD-1 agent administered during neoadjuvant treatment. Treatment will begin within 10 weeks after surgery and continue for up to 15 cycles unless disease recurrence, unacceptable toxicity, withdrawal of consent, or another protocol-defined discontinuation criterion occurs. Dose reduction is not permitted; treatment-related toxicity will be managed by treatment interruption or permanent discontinuation according to the protocol.

06

What researchers measure

Primary outcomes

  1. 1-Year Disease-Free Survival Rate

    The Kaplan-Meier estimated percentage of participants who are alive without local or regional recurrence, distant metastasis, or a second primary malignancy at 12 months after enrollment. Disease-free survival is measured from the date of enrollment to the first occurrence of disease recurrence, a second primary malignancy, or death from any cause, whichever occurs first.

    Time frame: At 12 months after enrollment

Secondary outcomes

  1. Disease-Free Survival

    Time from enrollment to the first documented local or regional recurrence, distant metastasis, second primary malignancy, or death from any cause, whichever occurs first. Participants without an event will be censored at the date of the last disease assessment.

    Time frame: From enrollment through 5 years after surgery

  2. Overall Survival

    Time from enrollment to death from any cause. Participants who are alive at the time of analysis will be censored at the date they were last known to be alive.

    Time frame: From enrollment through 5 years after surgery

  3. Patterns of Disease Recurrence

    The number and percentage of participants experiencing local recurrence, regional lymph node recurrence, or distant metastasis, as determined by imaging and pathological examination when clinically indicated. A participant may be included in more than one recurrence category if recurrence occurs at multiple sites.

    Time frame: From enrollment through 5 years after surgery

  4. Percentage of Participants With Treatment-Related Adverse Events

    The percentage of participants experiencing adverse events considered by the investigator to be related to anti-PD-1 immunotherapy, anlotinib, or their combination. Adverse events will be classified and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0. Grade 3 or higher treatment-related adverse events and adverse events of special interest will also be summarized.

    Time frame: From the first dose through completion or discontinuation of study treatment, up to 15 cycles (each cycle is 21 days).

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07830355
Responsible party
Jun Liu (Professor, Shanghai Chest Hospital) — Principal investigator
First posted
Sep 21, 2026
Start date
Sep 2026 (estimated)
Primary completion
Dec 2028 (estimated)
Completion
Dec 2029 (estimated)
Last update
Sep 21, 2026

Study contacts

Jun Liu, Dr
Contact
drjunliuplus@163.com
+86 18930859538

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Anlotinib

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