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The University of Southampton
Southampton Clinical Trials Unit

Neo-AEGIS Trial


NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study: Randomised Clinical Trial of neoadjuvant and adjuvant chemotherapy (Modified MAGIC regimen) vs. neoadjuvant chemoradiation (CROSS protocol) in adenocarcinoma of the oesophagus and oesophago-gastric junction 


Patients with cT2-3 N0-3 M0 adenocarcinoma of the oesophagus or junction, based on clinical, CT-PET, and EUS staging, will be randomised to the MAGIC chemotherapy regimen versus the CROSS neoadjuvant chemoradiation protocol prior to surgery. Patients will be randomised to either Arm A (modified MAGIC regimen of chemotherapy only and surgery) or Arm B (CROSS protocol: chemotherapy with radiation therapy and surgery as per multimodal protocol). 


Primary Objective:

To evaluate 1, 2 and 3 year survival of patients treated with resection plus neoadjuvant and adjuvant chemotherapy, versus resection plus neoadjuvant chemo radiotherapy.

Secondary Objective(s):

To evaluate the effect of both neoadjuvant regimens on clinical and pathological response rate, tumour regression grade, surgical resection rate, node-positivity, post-operative pathology, disease-free survival and time to treatment failure.

Trial Design

This is a multicentre phase III open-labelled, randomised controlled trial. Eligible patients will be randomised in a 1:1 fashion between the modified MAGIC regimen (ECF/ECX or EOF/EOX) or the multimodality therapy (CROSS protocol) with a modernised design and delivery of radiation therapy. 

Trial Status

Open to recruitment


Willing patients whom are eligible to consent must be male/female aged >18 years, have histologically verified adenocarcinoma of the oesophagus or oesophago-gastric junction based on OGD with adequate cardiac, respiratory, renal and liver functions.

Patients with advanced inoperable or metastatic oesophageal, junctional or gastric adenocarcinoma will be deemed ineligible, along with patients with prior chemotherapy for gastrointestinal cancer and/or other malignancies within the last 5 years. 

Trial Team:

Senior Trial Manager:

Jane Mellor (023 8120 3866)

Trial Manager:

Nadia Peppa (023 8120 3522)

Clinical Data Coordinator:

Emma Wrixon (023 8120 5687)

Contact information


Fax: 0844 7740 621


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