{"entity":{"id":"cross-then-nivolumab","kind":"pairing","name":"CROSS chemoradiation → surgery → adjuvant nivolumab if residual disease","aka":[],"tldr":"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.","summary":"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.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02743494: CheckMate 577","url":"https://clinicaltrials.gov/study/NCT02743494"}],"tags":[],"related":[],"cancers":["esophageal"],"sections":[],"technologies":[],"targets":[],"drugs":["nivolumab","carboplatin","paclitaxel"],"companies":[],"institutions":[],"pathways":[],"terms":["neoadjuvant-adjuvant","clinical-complete-response"],"trials":["cross","checkmate-577","sano"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"cross","b":"nivolumab","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.","pairingType":"sequence"},"route":"/pairings/cross-then-nivolumab/","neighbours":{"cancer":[{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"term":[{"id":"clinical-complete-response","kind":"term","name":"Clinical complete response (cCR)","route":"/terms/clinical-complete-response/"},{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"}],"trial":[{"id":"checkmate-577","kind":"trial","name":"CheckMate 577","route":"/trials/checkmate-577/"},{"id":"cross","kind":"trial","name":"CROSS","route":"/trials/cross/"},{"id":"sano","kind":"trial","name":"SANO","route":"/trials/sano/"}]}}