A pilot trial of FLOT neoadjuvant chemotherapy for resectable esophagogastric junction adenocarcinoma

Abstract

Docetaxel is active in esophagogastric junction (EGJ) adenocarcinoma, and DCF (docetaxel/cisplatin/5-fluorouracil) has shown good results in the neoadjuvant setting. Its high rate of grade 3-4 mucosal toxicity (stomatitis and diarrhea) has limited its widespread adoption. A more recent docetaxel-based triplet, FLOT (5-fluorouracil, oxaliplatin and docetaxel) may be better tolerated. We conducted a pilot study of FLOT chemotherapy in EGJ adenocarcinoma patients and dysphagia to prospectively assess the rate of grade 3-4 mucosal toxicity and of pathological complete response (pCR) rate. Dysphagia and quality of life were measured with validated questionnaires. Ten patients were enrolled. Grade 3-4 mucosal toxicity rate was 0 %; pCR rate was 11 %; and near-complete pathological response rate 11 %. Dysphagia improvement or resolution was seen in 90 % of patients, and quality of life was stable before and after chemotherapy. FLOT is a safe and active neoadjuvant chemotherapy option for EGJ adenocarcinoma and should be compared to other standard regimens in randomized trials.

A neoadjuvans FLOT-terápia hatása az előrehaladott gyomor-cardia tumorok rövid távú onkológiai és sebészi kezelés eredményeire

“…A későbbiekben sor került a módosított indikációs célú kezelések elindítására is. Ezekben az esetekben nemcsak az operabilitas elérése volt a kitűzött cél, hanem a szervmegtartásé is, a jobb onkológiai eredmények elérése mellett [7,8].…”

Impact of neoadjuvant FLOT treatment of advanced gastric and gastroesophageal junction cancer following surgical therapy

“…Treatments with modified indications were introduced later. In these cases, the objective was not only to achieve operability but also to preserve organs and achieve better oncological results ( 9 , 10 ).…”