Total Neoadjuvant Therapy Combined With Adebrelimab in Locally Advanced Resectable ESCC

Inclusion Criteria:

1. Sign a informed consent form and voluntarily join this study;
2. Esophageal squamous cell carcinoma diagnosed by histopathology or cytology;
3. Diagnosed as thoracic esophageal cancer by CT/MRI/EUS and clinically staged as T1b-3N1-2M0 or T3N0M0 (according to AJCC 8th edition);
4. Expected to achieve R0 resection;
5. Age ≥ 18 years old, regardless of gender;
6. ECOG PS 0-1;
7. Have not received any anti-tumor treatment for esophageal cancer in the past;
8. Plan to undergo surgical treatment after completion of neoadjuvant therapy;
9. No surgical contraindications;
10. The main organ functions are normal, including:

    1. Blood routine examination:

       neutrocyte count ≥ 1.5 × 109/L Platelet count ≥ 100 × 109/L Hemoglobin ≥ 90 g/L
    2. Blood biochemistry test:

       Total bilirubin ≤ 1.5 × ULN ALT ≤ 2.5×ULN，AST ≤ 2.5×ULN， Serum creatinine ≤ 1.5 × ULN, or creatinine clearance rate ≥ 50 mL/min (Cocheroft Gault formula, see Appendix 2)
    3. Coagulation function:

    INR ≤ 1.5 × ULN APTT ≤ 1.5 × ULN
11. Women who have the ability to conceive or men whose spouses have the ability to conceive should use effective contraceptive measures during the study period;
12. The subjects showed good compliance and cooperated with follow-up visits;

Exclusion Criteria:

1. Tumors or lymph nodes significantly invade adjacent organs of esophageal lesions;
2. Patients with supraclavicular lymph node metastasis;
3. Individuals at risk of perforation, fistula, etc;
4. There are uncontrollable pleural effusion, pericardial effusion, or ascites that require repeated drainage;
5. Poor nutritional status, BMI \< 18.5 Kg/m2；
6. Have a history of allergies to monoclonal antibodies, any components of Adebrelimab, paclitaxel, cisplatin, or other platinum based drugs in the past;
7. Have received or are currently receiving any of the following treatments:

   1. Any radiotherapy, chemotherapy, or other anti-tumor drugs targeting tumors;
   2. Within 2 weeks prior to the first use of the investigational drug, immunosuppressive or systemic hormone therapy was being used to achieve immunosuppressive effects;
   3. Received attenuated live vaccine within 4 weeks prior to the first use of the investigational drug;
   4. Having undergone major surgery or suffered severe trauma within 4 weeks prior to the first use of the investigational drug;
8. Suffering from any active autoimmune disease or history of autoimmune disease;
9. History of immunodeficiency, including HIV testing positive, or other acquired or congenital immunodeficiency diseases, or history of organ transplantation or allogeneic bone marrow transplantation;
10. There are clinical symptoms or diseases of the heart that have not been well controlled;
11. Severe infection (CTCAE\>grade 2) occurred within 4 weeks prior to the first use of the investigational drug;
12. Discovery of active pulmonary tuberculosis infection through medical history or CT examination;
13. Active hepatitis B and hepatitis C exist;
14. Diagnosed with other malignant tumors within 5 years prior to the first use of the investigational drug;
15. Pregnant or lactating women;
16. According to the researchers' assessment, there are other factors that may lead to the forced termination of the study midway.