The FLOT4 trial established FLOT (5-FU, leucovorin, oxaliplatin, docetaxel) as the preferred perioperative chemotherapy regimen for gastric and gastroesophageal junction adenocarcinoma over which earlier regimen?
- A FOLFOX (folinic acid, 5-FU, oxaliplatin) alone
- B ECF/ECX (epirubicin, cisplatin, 5-FU or capecitabine) — the MAGIC regimen ✓
- C Cisplatin plus gemcitabine
- D Capecitabine plus oxaliplatin with bevacizumab
Correct answer: B. ECF/ECX (epirubicin, cisplatin, 5-FU or capecitabine) — the MAGIC regimen
Explanation
The MAGIC trial (2006) established ECF perioperative chemotherapy (3 cycles pre-operative + 3 cycles post-operative) as the standard of care for resectable gastric/GEJ adenocarcinoma. The FLOT4 trial (Al-Batran et al., 2019) demonstrated that the 4-drug FLOT regimen improved R0 resection rates, pathological response, and significantly extended overall survival (50 months vs 35 months) compared to ECF/ECX, making FLOT the new standard perioperative regimen in fit patients.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.