In patient with upper esophageal SCC who had partial response to neoadjuvant chemoradiation but deemed not to be a surgical candidate, would you recommend chemotherapy or nivolumab?

Once again, there's no clear answer to these head scratchers. For the purpose of answering this question, I will assume that the patient has a locally persistent tumor s/p definitive chemoradiation and is medically inoperable.

In that case, the first issue to consider is whether there is a role for more loco-regional therapy. I'm not aware of any case series of such approaches as cryoablation or photodynamic therapy in this situation but our group has previously explored the role of brachytherapy in patients with locally recurrent or persistent disease (Taggar et al., PMID 29496425). This was a heterogenous group of patients but our series of 33 patients suggested improved local control with brachytherapy that was unfortunately not durable f...