NCCN Guidelines® Insights - Esophageal and Esophagogastric Junction Cancers, Version 4.2026

Esophageal cancer is the seventh leading cause of cancer-related deaths worldwide. Esophageal cancers are histologically classified as squamous cell carcinoma (ESCC) or adenocarcinoma (EAC), which differ in their etiology, pathology, tumor location, therapeutics, and prognosis. In patients with locally advanced or metastatic disease, systemic therapy can provide palliation, improve survival, and/or enhance quality of life. The implementation of biomarker testing and immunotherapy has had a significant impact on clinical practice and patient care. This selection from the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers highlights current recommendations for advanced ESCC, including the evolving landscape of first-line immunotherapy.

Target Audience

This journal article is designed to meet the educational needs of oncologists, nurses, pharmacists, and other healthcare professionals who manage patients with cancer. 

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Integrate into professional practice the updates to the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers
  • Describe the rationale behind the decision-making process for developing the NCCN Guidelines for Esophageal and Esophagogastric Junction Cancers

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Additional information
Supporters: 

This activity is supported by educational grants from AstraZeneca, Johnson & Johnson, Lantheus, Lilly, Novartis, and Recordati Rare Diseases Inc. This activity is supported by an independent medical education grant from GSK. This activity is supported by a medical education grant from Exelixis, Inc.

Course summary

Available credit: 
  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC contact hours
  • 1.00 Participation
Course opens: 
09/16/2026
Course expires: 
09/10/2027
Part of: 
Behind the Guidelines: Insights into the Standard of Care in Oncology 2026 (NCCN Guidelines® Insights 2026)

NCCN Continuing Education Disclosure Policy
It is the policy of NCCN that all planners, faculty, moderators, authors, reviewers and anyone involved in the planning and delivery of NCCN continuing education activities are expected to disclose ALL financial relationships they have had in the past 24 months with ineligible companies. The ACCME Standards for Integrity and Independence require that individuals who refuse to provide this information will be disqualified from involvement in the planning and implementation of accredited continuing education presented by NCCN. NCCN identifies, mitigates and discloses to learners all relevant financial relationships.

In addition, all content has been reviewed to ensure education promotes safe, effective patient care and does not promote the products or services of an ineligible company. Content, including any presentation of therapeutic options, is fair, balanced, evidence-based, scientifically accurate, and free of commercial bias and marketing. 

Definitions  

Ineligible Company: An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 

Relevant Financial Relationships: Financial relationships of any dollar amount occurring within the past 24 months are defined as relevant if the educational content an individual can control is related to the business lines or products of an ineligible company. There is no minimum financial threshold. We ask for disclosure of ALL financial relationships with ineligible companies, regardless of the amount and regardless of the potential relevance of each relationship to the education.

Faculty Disclaimers  

All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.

Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling or marketing.
 
Individuals Who Provided Content Development and/or Authorship Assistance
 
The faculty listed below have no relevant financial relationship(s) with ineligible companies to disclose.
 
Nicole McMillian, MS, Senior Guidelines Coordinator, NCCN
Nicholas Sansone, MFA, Guidelines Layout Specialist, NCCN
MaryElizabeth Stein, PhD, Associate Scientist/Medical Writer, NCCN
 
The faculty listed below have the following relevant financial relationship(s) with ineligible companies to disclose. All of the relevant financial relationships listed for these individuals have been mitigated.
 
Jaffer A. Ajani, MD, Panel Chair, has disclosed receiving grant/research support from BeiGene, Ltd., Bristol Myers Squibb, and Merck & Co., Inc.; receiving consulting fees from BeiGene, Ltd., Bristol Myers Squibb, Merck & Co., Inc., and Orion Corporation; and serving as a scientific advisor for Bristol Myers Squibb, Shanghai Henlius Biotech, Inc., Jazz Pharmaceuticals, Inc., and Merck & Co., Inc..
 
Thomas A. D’Amico, MD, Panel Vice Chair, has disclosed receiving royalty income from Scanlan International.
 
 
NCCN Staff Disclosures
 
None of the other planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.
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In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Physicians
NCCN designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
NCCN designates this educational activity for a maximum of 1.0 contact hour. 

Pharmacists
NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.1 CEUs) of continuing education credit. UAN: JA4008196-0000-26-009-H01-P

PAs
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credit. Approval is valid until September 10, 2027. PAs should only claim credit commensurate with the extent of their participation.

Available Credit

  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC contact hours
  • 1.00 Participation
Please login or register to take this course.

Required Hardware/software

To access this activity, users will need:

  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing