The FLOT4 trial changed the perioperative chemotherapy regimen for resectable gastric and gastroesophageal junction adenocarcinoma. Which regimen did FLOT replace as the new standard?
- A DCF (docetaxel, cisplatin, fluorouracil)
- B ECF (epirubicin, cisplatin, fluorouracil) — MAGIC trial regimen ✓
- C CAPOX alone
- D Cisplatin plus 5-FU with radiation (CROSS regimen)
Explanation
The FLOT4 trial (FLOT = docetaxel, oxaliplatin, leucovorin, fluorouracil) demonstrated superior overall survival (50 months vs 35 months) and pathological complete response rates compared to the ECF/ECX regimen established by the MAGIC trial. FLOT is now the standard perioperative chemotherapy for resectable gastric and GEJ adenocarcinoma in fit patients. DCF is used in palliative settings. CAPOX is used as adjuvant/palliative. The CROSS regimen (carboplatin/paclitaxel with concurrent radiation) is the standard for esophageal/GEJ squamous cell carcinoma and adenocarcinoma in the neoadjuvant setting.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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