A 60-year-old patient with locally advanced gastric cancer (cT3N2M0) is planned for perioperative chemotherapy. The FLOT4-AIO trial demonstrated superiority of which regimen over ECF/ECX for perioperative chemotherapy?
- A FOLFOX (oxaliplatin + leucovorin + 5-FU)
- B DCF (docetaxel, cisplatin, 5-FU)
- C FOLFIRI (irinotecan + leucovorin + 5-FU)
- D FLOT (5-FU, leucovorin, oxaliplatin, docetaxel) ✓
Explanation
The FLOT4-AIO phase III trial (Al-Batran et al., Lancet 2019) compared perioperative FLOT (5-FU, leucovorin, oxaliplatin, docetaxel — 4 cycles pre-op and 4 cycles post-op) versus ECF/ECX (epirubicin, cisplatin, 5-FU or capecitabine — MAGIC regimen) for resectable gastric/gastro-oesophageal junction adenocarcinoma. FLOT demonstrated superior median overall survival (50 months vs 35 months) and higher pathological complete response rate (15% vs 6%). FLOT is now the standard perioperative regimen for fit patients with locally advanced gastric/GEJ cancer in most European and increasingly international guidelines.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.