Chisthi MM, Viswanath S, Kuttanchettiyar KG. Precision immunotherapy in oesophageal squamous cell carcinoma: Molecular pathogenesis and checkpoint inhibitor response prediction. World J Gastrointest Pharmacol Ther 2026; 17(2): 119778 [DOI: 10.4292/wjgpt.v17.i2.119778]
Corresponding Author of This Article
Meer M Chisthi, Associate Professor, Department of General Surgery, Government Medical College Kollam, Kollam, Parippally 691574, Kerala, India. meerchisthi.m@tmc.kerala.gov.in
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Jun 5, 2026; 17(2): 119778 Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.119778
Precision immunotherapy in oesophageal squamous cell carcinoma: Molecular pathogenesis and checkpoint inhibitor response prediction
Meer M Chisthi, Sindhu Viswanath, Krishnakumar G Kuttanchettiyar
Meer M Chisthi, Krishnakumar G Kuttanchettiyar, Department of General Surgery, Government Medical College Kollam, Parippally 691574, Kerala, India
Sindhu Viswanath, Department of Ear Nose Throat, Government Medical College Trivandrum, Thiruvananthapuram 695011, Kerala, India
Co-first authors: Meer M Chisthi and Sindhu Viswanath.
Author contributions: Chisthi MM and Viswanath S drafted the manuscript, vetted the manuscript, have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Viswanath S and Kuttanchettiyar KG acquired and analyzed the data; all authors approved the final version to be published and agreed to be accountable for all aspects of the work.
AI contribution statement: An AI tool (DeepSeek) was used only to assist with language polishing, grammar improvement, and phrasing refinement after the original manuscript was fully written by the authors. No AI tool was used to generate scientific content, research data, interpretation, conclusions, or images. All intellectual work, study design, data analysis, and final approval remain solely the authors’ responsibility.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Meer M Chisthi, Associate Professor, Department of General Surgery, Government Medical College Kollam, Kollam, Parippally 691574, Kerala, India. meerchisthi.m@tmc.kerala.gov.in
Received: February 10, 2026 Revised: March 3, 2026 Accepted: April 2, 2026 Published online: June 5, 2026 Processing time: 111 Days and 4.7 Hours
Abstract
Oesophageal squamous cell carcinoma (ESCC) remains a significant global health challenge due to its aggressive nature and poor prognosis. Recent advances in immunotherapy, particularly immune checkpoint inhibitors (ICIs), have revolutionized treatment paradigms. This review comprehensively examines the molecular pathogenesis of ESCC, highlighting key oncogenic pathways and immune evasion mechanisms. Furthermore, it explores the evolving landscape of biomarkers and predictive models for ICI response, emphasizing the critical role of precision immunotherapy in tailoring treatment strategies. A deeper understanding of these molecular and immunological underpinnings is essential for optimizing patient selection, overcoming resistance, and ultimately enhancing therapeutic efficacy in ESCC.
Core Tip: Precision immunotherapy is transforming the management of oesophageal squamous cell carcinoma (ESCC). This review synthesizes current knowledge on the molecular drivers of ESCC and the complex tumour-immune interactions that dictate response to immune checkpoint inhibitors (ICIs). We detail established and emerging biomarkers-such as programmed death-ligand 1 expression, tumour mutational burden, and circulating tumour DNA-for predicting ICI efficacy. The discussion extends to mechanisms of resistance and future directions, including novel immune targets and multi-omics integration for personalized treatment strategies, aiming to guide clinicians and researchers toward more effective, tailored immunotherapeutic interventions.
