Are there patients for whom CROSS followed by surgery and adjuvant nivolumab should still be considered, following data from MATTERHORN and ESOPEC?

ESOPEC does not invalidate CROSS—it redefines the preferred option for fit patients; in the real world, not every patient will be able to tolerate FLOT or d-FLOT: Yes. Despite the emergence of perioperative FLOT-based strategies from ESOPEC and MATTERHORN, CROSS, followed by surgery and adjuvant niv...

In light of the results from the ESOPEC and MATTERHORN trials, the use of the CROSS regimen (followed by surgery and adjuvant nivolumab) has declined substantially at our institution for patients with gastroesophageal adenocarcinoma. Chemoradiation is now primarily reserved for definitive management...

As a first point, it's hard to justify the use of CROSS over FLOT based on the pretty resounding results of ESOPEC (Hoeppner et al., PMID 39842010).

Accepting this point, MATTERHORN further improves on the FLOT regimen with the addition of durvalumab.

On the other hand, the CheckMate 577 study did sho...

As said in previous comments, the ESOPEC study showed perioperative chemotherapy (FLOT4) led to a significantly improved OS and DFS compared to neoadjuvant chemoradiation (CROSS), without jeopardizing local regional control (numerically improved pCR for the FLOT4 arm). The subsequent MATTERHORN stud...