Neoadjuvant treatment with chemotherapy (FLOT) or chemoradiotherapy (CROSS) followed by surgery are widely used standards of care for patients with resectable, locally advanced oesophageal, gastro-oesophageal junction cancer, or gastric cancer (OC/GOJC/GC). However, the risk of recurrence remains high, especially among the 70–75% of patients who do not achieve a pathological complete response.1
In the absence of adjuvant treatment options post CROSS, clinicians have historically used a ‘wait and watch’ approach.2 However, an additional treatment option is available following positive phase 3 clinical trial results in patients with OC or GOJC.
Adjuvant immuno-oncology treatment is available for select patients with completely resected OC/GOJC who have received neoadjuvant chemoradiotherapy.3 As the choice of neoadjuvant treatment can impact adjuvant options, it is important for surgeons, oncologists and other members of the MDT to discuss treatment implications before initiating a neoadjuvant treatment plan in patients with resectable OC/GOJC.
HAS YOUR MDT DISCUSSED ALL OPTIONS?
CLICK HERE for more on immuno-oncology and the adjuvant treatment of resected OC/GOJC.
References: 1. Kelly et al. N Engl J Med 2021;384:1191–1203. 2. Blum Murphy et al. Cancer 2017;123:4106–4113.
3. OPDIVO® (nivolumab) Approved Product Information ( rss.medsinfo.com.au/bq/pi.cfm?product=bqpopdiv).
CROSS = carboplatin + paclitaxel + radiotherapy 41.4 Gy; FLOT = fluorouracil + leucovorin + oxaliplatin
+ docetaxel;
GOJC = gastro-oesophageal junction cancer; MDT = multidisciplinary team; OC = oesophageal cancer.
