{"entity":{"id":"cross-trial","kind":"trial","name":"CROSS","aka":[],"tldr":"CROSS made chemoradiation before surgery the standard for oesophageal cancer: five weeks of weekly chemotherapy with radiotherapy nearly doubled median survival compared with surgery alone.","summary":"CROSS randomised 368 patients with resectable oesophageal or gastro-oesophageal junction cancer to surgery alone or five weekly cycles of carboplatin-paclitaxel with 41.4 Gy in 23 fractions followed by surgery. Median overall survival was 49.4 months with chemoradiation versus 24.0 months with surgery alone (hazard ratio 0.66), 29 percent had a pathological complete response, and surgical complications were not increased (van Hagen and colleagues, New England Journal of Medicine 2012). Ten-year follow-up confirmed the benefit; the CROSS regimen is a worldwide standard.","status":"positive","asOf":"2026-09-17","links":[{"label":"NEJM 2012","url":"https://doi.org/10.1056/NEJMoa1112088"}],"tags":["radiation-wave4"],"related":[],"cancers":["esophageal","gastric"],"sections":[],"technologies":["imrt-igrt","radiosensitisers"],"targets":[],"drugs":["carboplatin","paclitaxel"],"companies":[],"institutions":[],"pathways":[],"terms":["chemoradiation"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"notes":[],"phase":"3","setting":"Resectable oesophageal or junctional cancer: neoadjuvant carboplatin-paclitaxel with 41.4 Gy radiotherapy then surgery, versus surgery alone","sponsor":"Dutch CROSS study group","result":"Median overall survival 49.4 vs 24.0 months (hazard ratio 0.66); pathological complete response 29%.","yearReported":2012,"enrolled":368,"outcomes":[{"endpoint":"Median overall survival","primary":true,"unit":"months","arms":[{"name":"Chemoradiation then surgery","n":178,"value":49.4},{"name":"Surgery alone","n":188,"value":24}]}]},"route":"/trials/cross-trial/","neighbours":{"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"oesophageal-adenocarcinoma","kind":"cancer","name":"Oesophageal and junctional adenocarcinoma","route":"/cancers/oesophageal-adenocarcinoma/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"},{"id":"oesophageal-squamous-cell-carcinoma","kind":"cancer","name":"Oesophageal squamous cell carcinoma","route":"/cancers/oesophageal-squamous-cell-carcinoma/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"radiosensitisers","kind":"technology","name":"Radiosensitisers","route":"/technologies/radiosensitisers/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"term":[{"id":"chemoradiation","kind":"term","name":"Chemoradiation (chemoradiotherapy, CRT)","route":"/terms/chemoradiation/"}]}}