The FLOT4 trial established FLOT (5-FU + leucovorin + oxaliplatin + docetaxel) as superior to ECF/ECX for resectable gastric and gastro-oesophageal junction adenocarcinoma. The primary endpoint demonstrated improved:
- A Pathological complete response rate only
- B Progression-free survival only
- C Overall survival (median 50 vs 35 months for FLOT vs ECF) ✓
- D R0 resection rate without OS benefit
Correct answer: C. Overall survival (median 50 vs 35 months for FLOT vs ECF)
Explanation
FLOT4 (Al-Batran, 2019) showed that perioperative FLOT chemotherapy (4 pre-op + 4 post-op cycles) significantly improved median OS (50 vs 35 months) and progression-free survival compared to ECF/ECX for resectable gastric and GEJ adenocarcinoma. pCR rate was also higher (16% vs 6%). FLOT has replaced ECF as the standard perioperative regimen in fit patients in Europe and is widely adopted globally.
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.