{"entity":{"id":"flot-term","kind":"term","name":"FLOT regimen (perioperative chemotherapy for gastric cancer)","aka":["FLOT4","FLOT regimen","perioperative FLOT","docetaxel quadruplet","ECF","ECX","MAGIC regimen"],"tldr":"Four cycles of chemotherapy before and four after surgery for stomach and junction cancer, using fluorouracil, leucovorin, oxaliplatin and docetaxel. It replaced the older ECF recipe after the FLOT4 trial and is now the Western standard.","summary":"The MAGIC trial (2006) established perioperative ECF; FLOT4 (2019) showed FLOT improved median survival from 35 to 50 months and raised complete pathological responses. Adding PD-1 blockade (MATTERHORN durvalumab, KEYNOTE-585) improved event-free survival, and trastuzumab and zolbetuximab are being tested in HER2-positive and claudin 18.2-positive disease. FLOT is toxic (neutropenia, neuropathy, diarrhoea) and only about half of patients complete the postoperative half, so ctDNA-guided and response-adapted variants are under study. East Asian practice favours D2 surgery followed by adjuvant S-1 or CAPOX instead.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Gastric_cancer#Treatment","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Gastric_cancer#Treatment"}],"tags":[],"related":["flot","gastrectomy","neoadjuvant-adjuvant","gej","folfox-family"],"cancers":["gastric","esophageal"],"sections":["chemotherapy"],"technologies":[],"targets":[],"drugs":["oxaliplatin","docetaxel","fluorouracil"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/flot-term/","neighbours":{"drug":[{"id":"docetaxel","kind":"drug","name":"Docetaxel","route":"/drugs/docetaxel/"},{"id":"flot","kind":"drug","name":"FLOT (5-FU, leucovorin, oxaliplatin, docetaxel)","route":"/drugs/flot/"},{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"}],"term":[{"id":"folfox-family","kind":"term","name":"FOLFOX, FOLFIRI, FOLFIRINOX and CAPOX","route":"/terms/folfox-family/"},{"id":"gastrectomy","kind":"term","name":"Gastrectomy","route":"/terms/gastrectomy/"},{"id":"gej","kind":"term","name":"Gastro-oesophageal junction (GEJ)","route":"/terms/gej/"},{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"}],"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"}]}}