{"entity":{"id":"oesophageal-squamous-cell-carcinoma","kind":"cancer","name":"Oesophageal squamous cell carcinoma","aka":["Esophageal squamous cell carcinoma","ESCC","Oesophageal SCC"],"tldr":"Squamous cell carcinoma of the oesophagus, the world's commonest form, is linked to smoking, alcohol and very hot drinks and sits in the upper and middle gullet. It is treated with chemoradiation, with or without surgery, and immunotherapy has recently joined chemotherapy for advanced disease.","summary":"Oesophageal squamous cell carcinoma arises from the squamous lining of the upper and middle oesophagus; tobacco, alcohol, scalding drinks, nutritional deficiency and achalasia are its causes, and TP53 and NOTCH1 mutations its genetics. Early lesions found by endoscopy, common in Japanese and Chinese screening programmes, are removed endoscopically. Locally advanced disease is treated either with neoadjuvant chemoradiation followed by surgery (CROSS) or with definitive chemoradiation alone, which cures a similar share in this histology; adjuvant nivolumab after chemoradiation and surgery lowers recurrence when residual disease remains (CheckMate 577). Advanced disease is treated with nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648) or pembrolizumab plus chemotherapy (KEYNOTE-590); Chinese trials with camrelizumab, tislelizumab, toripalimab and sintilimab have produced the same result.","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Esophageal_cancer","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Esophageal_cancer"}],"tags":["subtype-page"],"related":["oesophageal-adenocarcinoma"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-cross-nejm-2012","paper-checkmate-648-nejm-2022","paper-keynote-590-lancet-2021","paper-checkmate-577-nejm-2021"],"journals":[],"dependsOn":[],"notes":[],"group":"gastrointestinal","burden":"About 85 percent of oesophageal cancers worldwide and the dominant type across the Asian oesophageal cancer belt, East Africa and South America; in high-income countries it is now outnumbered by adenocarcinoma, and five-year survival is around 20 percent overall.","subtypes":["Upper and middle third squamous cell carcinoma","Early (T1a) squamous cell carcinoma (endoscopic resection)","Locally advanced (chemoradiation with or without surgery)","Metastatic (immunotherapy plus chemotherapy)"],"biomarkers":["PD-L1 combined positive score or tumour proportion score","TP53 and NOTCH1 mutations","Endoscopic Lugol staining for early lesions","Pathological response after chemoradiation"],"standardOfCare":[{"setting":"Early (T1a)","approach":"Endoscopic submucosal dissection; oesophagectomy or chemoradiation if deeper invasion is found.","refs":["endoscopic-resection"]},{"setting":"Locally advanced","approach":"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).","refs":["cross","carboplatin","paclitaxel","cisplatin","fluorouracil","nivolumab","checkmate-577"]},{"setting":"Metastatic, first line","approach":"Nivolumab plus chemotherapy or nivolumab plus ipilimumab (CheckMate 648), or pembrolizumab plus chemotherapy (KEYNOTE-590).","refs":["nivolumab","ipilimumab","pembrolizumab","checkmate-648","keynote-590"]},{"setting":"Prevention and screening","approach":"Smoking cessation, alcohol reduction, avoiding very hot drinks; endoscopic screening in high-incidence regions of China.","refs":["smoking-cessation-after-diagnosis","alcohol-reduction-labelling"]}],"stateOfArt":["Immunotherapy added to chemotherapy improved survival in every first-line trial, including several run entirely in China.","Organ preservation with definitive chemoradiation and surveillance is an accepted alternative to surgery in this histology.","Endoscopic screening in China detects a large share of cancers at a curable stage."],"history":[{"year":1992,"title":"RTOG 85-01: chemoradiation beats radiotherapy alone","refs":[]},{"year":2012,"title":"CROSS: chemoradiation before surgery doubles survival","refs":["cross"]},{"year":2021,"title":"CheckMate 577 and KEYNOTE-590 bring immunotherapy to oesophageal cancer","refs":["checkmate-577","keynote-590"]},{"year":2022,"title":"CheckMate 648: nivolumab combinations first line","refs":["checkmate-648"]}],"pipeline":["nivolumab","tislelizumab"],"openProblems":["Whether surgery can be omitted after a complete response to chemoradiation.","Most cases worldwide present late without access to endoscopy.","Nutrition, swallowing and quality of life during and after treatment."],"parent":"esophageal"},"route":"/cancers/oesophageal-squamous-cell-carcinoma/","neighbours":{"cancer":[{"id":"oesophageal-adenocarcinoma","kind":"cancer","name":"Oesophageal and junctional adenocarcinoma","route":"/cancers/oesophageal-adenocarcinoma/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"}],"paper":[{"id":"paper-checkmate-577-nejm-2021","kind":"paper","name":"CheckMate 577: adjuvant nivolumab in resected oesophageal or gastro-oesophageal junction cancer","route":"/key-papers/paper-checkmate-577-nejm-2021/"},{"id":"paper-checkmate-648-nejm-2022","kind":"paper","name":"CheckMate 648: nivolumab combination therapy in advanced oesophageal squamous cell carcinoma","route":"/key-papers/paper-checkmate-648-nejm-2022/"},{"id":"paper-cross-nejm-2012","kind":"paper","name":"CROSS: preoperative chemoradiotherapy for oesophageal or junctional cancer","route":"/key-papers/paper-cross-nejm-2012/"},{"id":"paper-keynote-590-lancet-2021","kind":"paper","name":"KEYNOTE-590: pembrolizumab plus chemotherapy for first-line treatment of advanced oesophageal cancer","route":"/key-papers/paper-keynote-590-lancet-2021/"}],"trial":[{"id":"nct06769113","kind":"trial","name":"A Phase II Clinical Study to Evaluate HLX43 in Patients With Recurrent/Metastatic ESCC Failed or Intolerance to Standard Therapy","route":"/trials/nct06769113/"},{"id":"nct07554456","kind":"trial","name":"A Study of BL-B01D1 in Combination With Tislelizumab ±5-Fluorouracil Versus Platinum-Based Chemotherapy Plus Tislelizumab as First-line Treatment in Patients With Unresectable, Locally Advanced Recurrent or Metastatic Esophageal Squamous Cell Carcinoma(PANKU-Esophagus02)","route":"/trials/nct07554456/"},{"id":"nct06644781","kind":"trial","name":"A Study of Ifinatamab Deruxtecan in Subjects With Pretreated Advanced or Metastatic Esophageal Squamous Cell Carcinoma (ESCC) (IDeate-Esophageal01)","route":"/trials/nct06644781/"},{"id":"nct06194734","kind":"trial","name":"A Study of KC1036 Versus Investigator's Choice of Chemotherapy in Patients With Advanced Esophageal Cancer","route":"/trials/nct06194734/"},{"id":"nct06022861","kind":"trial","name":"A Study to Compare the Efficacy and Safety of LY01015 and Opdivo® Combined Respectively With Chemotherapy in Advanced or Metastatic Esophageal Squamous Cell Carcinoma","route":"/trials/nct06022861/"},{"id":"checkmate-577","kind":"trial","name":"CheckMate 577","route":"/trials/checkmate-577/"},{"id":"checkmate-648","kind":"trial","name":"CheckMate 648","route":"/trials/checkmate-648/"},{"id":"nct02628665","kind":"trial","name":"Clinical Study of Time Optimizing of Endoscopic Photodynamic Therapy on Esophageal and/or Gastric Cardiac Cancer","route":"/trials/nct02628665/"},{"id":"nct04275986","kind":"trial","name":"Concurrent Chemoradiotherapy After Endoscopic Resection for Stage I Esophageal Carcinoma","route":"/trials/nct04275986/"},{"id":"cross","kind":"trial","name":"CROSS","route":"/trials/cross/"},{"id":"nct07481058","kind":"trial","name":"KC1036 in Combination With PD-1 Antibody and Platinum-based Chemotherapy for First-line Advanced Esophageal Cancer","route":"/trials/nct07481058/"},{"id":"keynote-590","kind":"trial","name":"KEYNOTE-590","route":"/trials/keynote-590/"},{"id":"nct07463573","kind":"trial","name":"QLC5508 vs. Chemotherapy in Pretreated Advanced or Metastatic Esophageal Squamous Cell Carcinoma","route":"/trials/nct07463573/"},{"id":"nct07700667","kind":"trial","name":"SKB500 Combinations in Patients With Esophageal Squamous Cell Carcinoma","route":"/trials/nct07700667/"},{"id":"nct06599775","kind":"trial","name":"Study of Adebrelimab With Chemotherapy, Endoscopy and Sequential Chemoradiotherapy In Inoperable Esophageal Cancer","route":"/trials/nct06599775/"},{"id":"nct04550260","kind":"trial","name":"Study of Durvalumab Versus Placebo in Combination With Definitive Chemoradiation Therapy in Patient With ESCC","route":"/trials/nct04550260/"},{"id":"nct04415853","kind":"trial","name":"Study of Larotinib in Unresectable Advanced or Recurrent Esophageal Cancer","route":"/trials/nct04415853/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"ipilimumab","kind":"drug","name":"Ipilimumab","route":"/drugs/ipilimumab/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"},{"id":"tislelizumab","kind":"drug","name":"Tislelizumab","route":"/drugs/tislelizumab/"}],"technology":[{"id":"alcohol-reduction-labelling","kind":"technology","name":"Alcohol reduction, pricing and cancer warning labels","route":"/technologies/alcohol-reduction-labelling/"},{"id":"endoscopic-resection","kind":"technology","name":"Endoscopic resection (EMR / ESD)","route":"/technologies/endoscopic-resection/"},{"id":"smoking-cessation-after-diagnosis","kind":"technology","name":"Smoking cessation in cancer patients","route":"/technologies/smoking-cessation-after-diagnosis/"}],"person":[{"id":"jong-mu-sun","kind":"person","name":"Jong-Mu Sun","route":"/people/jong-mu-sun/"},{"id":"yuichiro-doki","kind":"person","name":"Yuichiro Doki","route":"/people/yuichiro-doki/"}],"institution":[{"id":"osaka-university","kind":"institution","name":"Osaka University Graduate School of Medicine / Osaka University Hospital","route":"/institutions/osaka-university/"}],"biomarker":[{"id":"pd-l1-cps","kind":"biomarker","name":"PD-L1 CPS (combined positive score)","route":"/biomarkers/pd-l1-cps/"}],"target":[{"id":"clip1","kind":"target","name":"CLIP1","route":"/targets/clip1/"},{"id":"msn","kind":"target","name":"MSN","route":"/targets/msn/"},{"id":"rap1gds1","kind":"target","name":"RAP1GDS1","route":"/targets/rap1gds1/"},{"id":"tec","kind":"target","name":"TEC","route":"/targets/tec/"},{"id":"zbtb16","kind":"target","name":"ZBTB16","route":"/targets/zbtb16/"}]}}