# CROSS chemoradiation → surgery → adjuvant nivolumab if residual disease

Source: https://onco.cc/pairings/cross-then-nivolumab/  
OnCo record `cross-then-nivolumab` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Chemotherapy and radiation, then surgery, then a year of immunotherapy if the operation shows cancer was still there. This is the current curative-intent pathway.

## Summary

CROSS gives 10-year OS of 38%; CheckMate 577 adds DFS 22.4 vs 11.0 months in the ~70% with residual disease after resection (OS HR 0.85, not significant). Patients with pathologic complete response do not receive nivolumab. SANO offers surveillance instead of surgery for clinical complete responders.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: CROSS + Nivolumab
- Type: sequence
- Rationale: Residual disease after chemoradiation marks high relapse risk; radiation-induced immunogenic cell death primes T cells that PD-1 blockade sustains.
- Evidence: Phase 3 for each step (CROSS, CheckMate 577); the sequence is guideline standard.

## Sources

- ClinicalTrials.gov NCT02743494: CheckMate 577: https://clinicaltrials.gov/study/NCT02743494

## Connected records

- cancers: [Oesophageal cancer](https://onco.cc/cancers/esophageal/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- terms: [Clinical complete response (cCR)](https://onco.cc/terms/clinical-complete-response/), [Neoadjuvant / adjuvant / perioperative](https://onco.cc/terms/neoadjuvant-adjuvant/)
- trials: [CheckMate 577](https://onco.cc/trials/checkmate-577/), [CROSS](https://onco.cc/trials/cross/), [SANO](https://onco.cc/trials/sano/)

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