Oesophageal squamous cell carcinoma
Prepared with OnCo (onco.cc/prep/oesophageal-squamous-cell-carcinoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
17 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example PD-L1 combined positive score or tumour proportion score, TP53 and NOTCH1 mutations, Endoscopic Lugol staining for early lesions, Pathological response after chemoradiation), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (early (t1a)), which of the standard options do you recommend and why?
- 6.For my situation (locally advanced), which of the standard options do you recommend and why?
- 7.Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, Cisplatin or related drugs, and what side effects should I expect?
- 8.How do the results of CROSS and CheckMate 577 apply to someone like me?
- 9.For my situation (metastatic, first line), which of the standard options do you recommend and why?
- 10.Am I a candidate for Nivolumab, Ipilimumab, Pembrolizumab, and what side effects should I expect?
- 11.How do the results of CheckMate 648 and KEYNOTE-590 apply to someone like me?
- 12.For my situation (prevention and screening), which of the standard options do you recommend and why?
- 13.Are there clinical trials I could join, for example of Nivolumab, Tislelizumab?
- 14.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 15.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 16.I read that “Whether surgery can be omitted after a complete response to chemoradiation”. How does that affect my plan?
- 17.I read that “Most cases worldwide present late without access to endoscopy”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: PD-L1 combined positive score or tumour proportion score, TP53 and NOTCH1 mutations, Endoscopic Lugol staining for early lesions, Pathological response after chemoradiation.
Scans and tests linked to this cancer: Endoscopic resection (EMR / ESD).
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Prevention and screening: Smoking cessation, alcohol reduction, avoiding very hot drinks; endoscopic screening in high-incidence regions of China. (Smoking cessation in cancer patients, Alcohol reduction, pricing and cancer warning labels)
- Early (T1a): Endoscopic submucosal dissection; oesophagectomy or chemoradiation if deeper invasion is found. (Endoscopic resection (EMR / ESD))
- Locally advanced: Neoadjuvant carboplatin-paclitaxel chemoradiation and surgery (CROSS), or definitive cisplatin-fluorouracil chemoradiation with surgery reserved for persistent disease; adjuvant nivolumab after incomplete response (CheckMate 577). (CROSS, Carboplatin, Paclitaxel / nab-paclitaxel, Cisplatin, Fluorouracil (5-FU), Nivolumab, CheckMate 577)
- Metastatic, first line: Nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648), or pembrolizumab plus chemotherapy (KEYNOTE-590). (Nivolumab, Ipilimumab, Pembrolizumab, CheckMate 648, KEYNOTE-590)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.