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Objective:Several and-programmed cell death 1 (anti-PD-1) antibodies have demonstrated potential efficacy in the treatment of advanced esophageal squamous cell cancer (ESCC).However,the response to subsequent chemotherapy after the failure of PD-1 blockade in ESCC patients has not been reported,and the optimal sequencing of immunotherapy and chemotherapy remains controversial.The aim of the present study was to evaluate responses to irinotecan-based subsequent chemotherapy in advanced ESCC patients who had progressed after treatment with camrelizumab (SHR-1210),a novel anti-PD-1 antibody.Methods:We retrospectively reviewed the medical records of patients with advanced ESCC treated with camrelizumab at a single institution.Consecutive patients who received subsequent irinotecan-based chemotherapy were selected for data collection and analysis.Results:Overall,a total of 28 patients were included.All patients had received at least two lines of systemic treatment prior to irinotecan salvage.The most common regimen that was administered after PD-1 blockade was irinotecan in combination with 5-fluorouracil (5-Fu) (or its derivatives),which was given to 19 patients.The objective response rate (ORR) and disease control rate (DCR) were 17.9% (5/28) and 64.3% (18/28),respectively,with 5 (17.9%) patients achieving a partial response and 13 (46.4%) having stable disease.The median progression-free survival (PFS) was 3.18 [95% confidence interval (95% CI),2.48-3.88] months and the median overall survival (OS) was 6.23 (95% CI,4.71-7.75) months.No new safety issues,either immune-related or otherwise,were observed.Conclusions:Our results suggested that the response to irinotecan-based chemotherapy after PD-1 blockade in advanced ESCC patients appeared similar to that previously observed in patients who had not received PD-1 antibodies,and farther study in larger cohorts or randomized trials is warranted to verify our observation.