OnCo
pairingsPairing

CROSS chemoradiation → surgery → adjuvant nivolumab if residual disease

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.

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.

CROSS→ thenNivolumabsequence
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.

Connected

9top