Esophageal Cancer   

Questions discussed in this category



While ESOPEC excluded squamous cell carcinoma, the Japanese JCOG1109 NExT trial also showed superiority of fluoropyrimidine/platinum/taxane over chemo...

Would you use nivolumab or a taxane? Is the data from the ATTRACTION-3 trial with an all-Asian patient population applicable to practice to the US pop...

Assume the patient is a good surgical candidate, and the perforation happened prior to initiating any treatment. Is the stent enough reason to avoid c...

ESOPEC compared perioperative FLOT vs neoadjuvant chemoradiation per the CROSS trial, and showed superior OS with perioperative FLOT. What concerns do...

In general, how does an esophageal stent affect what you might consider in terms of radiation dose and volume?

Would you ever treat with definitive intent in a "curative" patient who has a stent placed, or only palliatively? Does the addition of chemotherapy or...

Assuming duodenum constraints are met, could there be any benefit to boosting a positive celiac node to 61.6 Gy in 28 fractions?

Would you only give three cycles with radiation, or are you adding two more cycles of FOLFOX afterwards?

Would it make a difference whether the patient was planned for chemoradiation followed by surgery or definitive nonoperative chemoradiation?

How would your decision differ if the patient was not on immunotherapy or other systemic therapy? Would your thinking differ depending on the timing o...

What other molecular tests do you routinely order on such tumors?

Do you proceed with chemotherapy alone, neoadjuvant chemoRT, or definitive chemoRT? How do you communicate treatment intent to the patient?

What would your approach be in a patient with a mid-esophageal squamous cell carcinoma treated with chemoradiation therapy followed by surgery, with P...

If so, how many cycles would you give? Both the MAGIC and FLOT trials showed difficulty with administering adjuvant chemotherapy.

Is it necessary to test CPS given the FDA approvals are not contingent on CPS %?  If you do test, do you check 28-8 (nivolumab), 22C3 (pembroliz...

Would you use reduced dose chemoimmunotherapy, single agent chemotherapy, or single agent immunotherapy if the patient is unlikely to tolerate full do...

Do you view CPS < 1% or 1-4% separately? Do you view the incremental benefit of adding immunotherapy still advantageous given relatively poor outco...

Do you go by FDA approval alone, or incorporate other data into your treatment decisions?  How do you view updated recent presentation of CM-649 ...

Would you ever consider adjuvant chemotherapy rather than adjuvant immunotherapy after the publication of the CM-577 results? If so, in which pop...

Are there other treatment variations by clinical subsets (eg tumor location, histology, stage II vs III, other biomarkers) seen in CM577 or other data...

CheckMate 577 only included patients with R0 resection.For R1 resections, guidelines suggest observation vs re-resection only.  

In the case of multiple skip lesions in the thoracic esophagus and GE junction, the PTV may encompass nearly the entire esophagus, including the supra...

The upfront plan is to use a definitive radiation dose of 66 Gy. My reading supports the use of 5FU + cisplatin but another doctor is recommending FOL...

As a for instance, a centrally located primary tumor with mediastinal adenopathy that results in a TE fistula? Currently we would recommend esophagea...

What chemotherapy and radiation doses/fractionation would you use once the airway has been stabilized to provide reasonably safe and effective palliat...

If the patient has large, bulky nodes would you consider starting after chemotherapy for cytoreduction? Or otherwise consider replanning mid-treatment...

I.e. Would you treat most of the normal esophagus to include a mediastinal lymph node? 

What regional lymph nodes do you include perigastric, portahepatic, periesophageal, celiac, splenic, pancreaticoduodenal, sup. mesenteric, paraesophag...

We use PET for esophageal, but not gastric cancer. GE junction seems like a grey area. 

Does the advent of FLOT in gastric cancers, change your approach to GE adeno's? Would anyone consider FLOT followed by chemoradition followed by surge...


Papers discussed in this category


The New England journal of medicine, 2001-09-06

J. Clin. Oncol., 2009-02-20

International journal of radiation oncology, biology, physics, 2007-02-01

Annals of surgical oncology, 2016-11

The Journal of thoracic and cardiovascular surgery, 2007 Aug

Eur J Cancer, 2022 Sep 19

Lancet Oncol., 2015-09-01

JAMA oncology, 2018-01-01

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2006-03

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002-03-01

J Clin Oncol, 2007 Apr 1

J Clin Oncol, 2005 Apr 1

Current oncology reports, 2019-04-04

Int. J. Radiat. Oncol. Biol. Phys., 2016 Sep 03

Int. J. Radiat. Oncol. Biol. Phys., 2017 Jan 09

Dis. Esophagus,

International journal of radiation oncology, biology, physics, 2015-07-15

JAMA, 1999-05-05

Pract Radiat Oncol, 2012 Oct-Dec

Curr Oncol, 2012-04-01

N. Engl. J. Med., 2012-05-31

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-07-01

J. Clin. Oncol., 2016-08-10

Lancet Oncol., 2014-07-01

Ann. Oncol., 2014-07-01

J. Clin. Oncol., 2015-10-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012-12-10

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-03-20

J. Clin. Oncol.,

N Engl J Med, 2007 Aug 16

The New England journal of medicine, 1999-08-12

Cancer, 2012-06-01

Cancer, 2016-07-01

International journal of radiation oncology, biology, physics, 2016-03-15

J Gastrointest Cancer,

Int. J. Radiat. Oncol. Biol. Phys., 2008 Jan 30

Thorac Surg Clin,

Lancet Oncol., 2014 Feb 18

The New England journal of medicine, 2018-12-06

Lancet, 2019 Oct 04

Pancreas,

British journal of cancer, 2011-06-07

N Engl J Med, 2021-04-01

Future Oncol, 2021 Feb 03

JAMA Oncol,

Annals of surgery, 2009-05

Lancet, 2021 Jun 05

J Clin Oncol, 2021 Dec 03

JAMA Oncol,

Lancet Oncol, 2022 Jan 11

Lancet,

Brachytherapy, 2018

The New England journal of medicine, 2022 Feb 03

Int J Radiat Oncol Biol Phys, 2022 Jul 04

Lancet Oncol., 2016 Jan 26

J Natl Compr Canc Netw, 2019 Jul 1

Journal of vascular and interventional radiology : JVIR, 2005-01

Nature, 2021 Dec 15

J Clin Oncol, 2023 Jan 05

J Clin Oncol, 2021 Jun 02

Journal of applied clinical medical physics, 2013-07-08

International journal of radiation oncology, biology, physics, 2017-11-15

Int J Radiat Oncol Biol Phys, 2020 Aug 25

Gastrointestinal endoscopy, 2011-06

Endoscopy, 2013

International journal of clinical oncology, 2003 Dec

AJR. American journal of roentgenology, 2012 Feb

The oncologist, 2018 May 04

The Lancet. Oncology, 2019 Sep 30

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020 Oct 07

Clinical cancer research : an official journal of the American Association for Cancer Research, 2019 Jul 23

BMC cancer, 2021 Nov 10

Cancer medicine, 2019 Jul 04

BMJ (Clinical research ed.), 2018 Sep 10

Scientific reports, 2023 May 31

Lancet Oncol., 2007-09-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-11-01

Lancet (London, England), 2024 Jun 11

The lancet. Gastroenterology & hepatology, 2023 Sep 18

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2009-03

Annals of oncology : official journal of the European Society for Medical Oncology, 2022 Jul 29