FLOT Is Superior to ECF/ECX Among Patients With Gastric Cancer

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Perioperative FLOT significantly improved PFS and OS among patients with resectable gastric cancers compared with standard ECF/ECX.
Perioperative FLOT significantly improved PFS and OS among patients with resectable gastric cancers compared with standard ECF/ECX.
The following article features coverage from the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois. Click here to read more of Cancer Therapy Advisor's conference coverage.

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.1

Professor Salah-Eddin Al-Batran of the Institute of Clinical Oncology Research in Germany presented the data.

FLOT4 is a phase 3, randomized trial (ClinicalTrials.gov Identifier: NCT01216644) conducted for patients with resectable gastric or gastroesophageal junction (GEJ) adenocarcinomas. Patients were randomly assigned to FLOT or to ECF/ECX, which are the standard of care.

Of 716 patients enrolled, 360 patients received ECF/ECX and 356 patients received FLOT. Baseline characteristics across the 2 arms were similar with respect to gender, age, disease stage, and type of cancer.

In the ECF/ECX arm, 91% and 37% of patients completed the planned preoperative and postoperative treatments. Correspondingly, in the FLOT arm, 90% and 50% of patients completed the planned preoperative and postoperative treatments.

After a median follow up of 43 months, median OS was 35 months with ECF/ECX and 50 months with FLOT (hazard ratio, 0.77; P = .012). Three-year OS was 48% for ECF/ECX and 57% for FLOT.

FLOT also significantly improved PFS, with a median of 30 months with FLOT and 18 months with ECF/ECX.

Perioperative complications were similar across the 2 arms: 50% with ECF/ECX and 51% with FLOT. More cases of grade 3 to 4 nausea and vomiting were seen with ECF/ECX and more cases of grade 3 to 4 neutropenia were seen with FLOT.

RELATED: Pembrolizumab Active in Advanced Gastric Cancer

“FLOT is the new standard of care in perioperative treatment of patients with adenocarcinomas of the stomach or gastroesophageal junction,” Prof Al-Batran concluded.

Read more of Cancer Therapy Advisor's coverage of the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting by visiting the conference page.

Reference

  1. 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).

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