FLOT for gastric cancer = pro
Epirubicin-cisplatin-5-fluorouracil (ECF) is commonly used to treat advanced gastric cancer. Two new cytotoxic agents: the platinum, oxaliplatin, and the oral fluoropyrimidine, capecitabine, have the potential to replace the cisplatin and 5-fluorouracil (5-FU) components of ECF, respectively. In this case, the regimen is capecitabine, Oxaliplatin and epirubicin.
The FLOT regimen is not very well studied. A recent rpesentation at ASCO suggests taht ti si superior, but the study had not been published. .Perioperative chemotherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) significantly improved progression-free survival (PFS) and overall survival (OS) among patients with resectable gastric cancers compared with epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX), according to data presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois. We await peer review and comments and incorporation into guidelines before full adoption.
NCCN, Gastric Cacner 2017
Al-Batran SE, Homann N, Schmalemberg H, et al. Perioperative chemotherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) for resectable gastric or gastroesophageal junction (GEJ) adenocarcinoma (FLOT4-AIO): a multicenter, randomized phase 3 trial. J Clin Oncol. 2017;35(suppl; abstr 4004