The ESOPEC trial (NEJM 2025) is a landmark phase III study directly comparing perioperative FLOT chemotherapywith neoadjuvant CROSS chemoradiotherapy in resectable esophageal and gastroesophageal junction adenocarcinoma.

✅ Key findings:

Median OS: 66 months (FLOT) vs 37 months (CROSS)

5-year OS: 50.6% vs 38.7%

PFS benefit: HR 0.66 (95% CI 0.51–0.85)

Distinct recurrence and toxicity patterns between arms

Take-home message:
FLOT is the new standard for adenocarcinoma, while CROSS remains pivotal for squamous cell carcinoma.

📺 I’ve broken down the methodology, outcomes, strengths, and limitations of ESOPEC in detail on my YouTube channel – Journal Club Oncology. 👉 Watch the full Journal Club discussion on YouTube:
https://youtu.be/aleVBk9PbbU