ESOPEC — Perioperative FLOT Versus Neoadjuvant CROSS Chemoradiation in Resectable Esophageal Adenocarcinoma (ESOPEC)

Phase 3 · 2025 · Esophageal Cancer

Design

Randomized trial of perioperative FLOT chemotherapy versus neoadjuvant CROSS chemoradiation (carboplatin-paclitaxel plus 41.4 Gy), both followed by surgery.

Population

Resectable esophageal adenocarcinoma (cT1 cN+ or cT2-4a cNany).

Primary Endpoint

overall survival (OS)

Key Result

Median OS 66 vs 37 months and 3-year OS 57.4% vs 50.7% (HR 0.70) favoring perioperative FLOT over CROSS chemoradiation.

Guideline Impact

Supports perioperative FLOT as a preferred strategy for resectable esophageal/GEJ adenocarcinoma