Objective To analyze the clinical efficacy and safety of programmed death 1 (PD-1) inhibitors combined with anlotinib as the second-line therapy in treating patients with advanced esophageal squamous cell carcinoma.

Methods A total of 68 patients with advanced esophageal squamous cell carcinoma diagnosed by histopathology from January 2021 to June 2022 were selected, and they were treated with PD-1 inhibitors plus arotinib targeted therapy after failure of first-line platinum containing chemotherapy regimen, including 32 cases with camrelizumab, 20 cases with sintilimab, and 16 cases with treprinumab immunotherapy. The clinical efficacy and safety of three groups were analyzed.

Results After efficacy evaluation for 68 patients, there were 18 cases of partial remission, 40 cases of stable disease, and 10 cases of disease progression. The objective response rate and disease control rate were 26.5% and 85.3% respectively, the median progression free survival was 7.5 months (95%CI, 6.6 to 8.4), and the median overall survival was not achieved. In terms of safety, the most adverse reactions were at grade 1 and 2, the incidence of adverse reactions at grade 3 was 14.7%, and adverse reactions at grade 4 and 5 were not observed; all the adverse reactions alleviated after performing targeted treatment.

Conclusion Patients with advanced esophageal squamous cell carcinoma can significantly benefit from the combination of PD-1 inhibitors and anlotinib as the second-line therapy, and the adverse reactions are controllable.