2020NCCN食管和胃食管结合部腺癌更新要点(全文).docx

2020NCCN食管和胃食管结合部腺癌更新要点（全文） 01% 2020 V4 更新自 V3 Updates in Version 4.2020 of the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers from Version 3.2020 include: MS-1 ?The Discussion has been updated to reflect the changes in the algorithm. 02. 2020 V3 更新自 V2 ESOPH-F——系统治疗原则：不可切除局部晚期.复发或转移性疾病 PRINCIPLES OF SYSTEMIC THERAPY Second丄inc 5 SubscouGnt Thcmp” Dependent on prior therapy and PS Proforrod RgQimens Ramucirumab and paclitaxel for adenocarcinoma (category 1 for EGJ adenocarcinoma; category 2A for esophageal adenocarcinoma)42 Docetaxel (category Ip2-33 Paclitaxel (category I ? Niyolumab for esophageal squamous cell carcinoma (category Trtfiurtdkne and tlplraclllor duJ acienocarcinoma (category If0 ? For third-line or subsequent therapy Fluorouracil and irinotecan44"? Pembrollzumabflh For seco nd-line therapy for esophageal squamous cell carcinoma, with PD-L1 expression levels by CPS of ^10 (category I)51 For second-line or subsequent therapy for MSI-M or dMMR tumocs52Useful in Certain Circiifn?t8i>ee? Fluorouracil and Irinotecam ?for bdefixacinoma (category 2B)b Useful in Certain Circiifn?t8i>ee? Fluorouracil and Irinotecam ?for bdefixacinoma (category 2B)b〕a ^Leucovcxin is indicated vwtii ceften fluocourMCil-based regimens Depending on uvaiUbitty these regimens may be us?d with or without leucovorin. For important information regarding th? leucovorr shcrUge ptease iee the Dixcusskki. ^Cspcdtabmo canrxx bo used ntorchflngMfy with fluonx)r?c? in rogimeHs containing rmctecsn 吊 no previous tTGatmont with a chedcpoint hhextor "See NCCN Guddlrtas for of IrnrmmothefBD+Raialfid Taocc血- 'Pemtrolkuniab h FDA-appcoved for the !hrd4lr?3 treeiment of peOents *lth EGJ odenocarcifxwna ?<th POL 1 expressioci levoh W CPS of ^1.88 determined by an FDA-approved companion diagnostic test The NCC忖 Pane* rocrxTvwnds ttuat (Mb pemtxolkuniab treeiment option be extended to patients wfth esoc^ageel ai^fXKarcinomas with PO-L1 expression tevels by CPS of For mao Iniormat