{"entity":{"id":"flot","kind":"drug","name":"FLOT (5-FU, leucovorin, oxaliplatin, docetaxel)","aka":[],"tldr":"FLOT is the four-drug chemotherapy given before and after surgery for stomach cancer in the West; since 2025 immunotherapy is added to it.","summary":"FLOT4-AIO (2019): perioperative FLOT beat ECF/ECX (OS 50 vs 35 months). MATTERHORN added durvalumab (OS HR 0.78; FDA approval November 2025). Four cycles before and four after gastrectomy. Neutropenia, neuropathy, and diarrhoea; tolerability limits use in frail patients, where FOLFOX or CAPOX substitute.","status":"standard-of-care","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/FLOT","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/FLOT"}],"tags":[],"related":["folfox"],"cancers":["gastric","esophageal","oesophageal-adenocarcinoma"],"sections":[],"technologies":["cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["flot-term"],"trials":["matterhorn","nct07775287","nct07228832","nct07621718","nct06535607","nct07790510","nct04430738","nct04083599","nct06792695","nct07805551","nct06820463","nct06948448","nct06219941","nct06943820","nct05919264","nct04421820","nct07432295","nct07474727","nct05382442","nct05379595","nct06428409"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"modality":"Cytotoxic regimen","mechanism":"Docetaxel stabilises microtubules; oxaliplatin crosslinks DNA; 5-FU/leucovorin inhibit thymidylate synthase.","approvals":[],"mechanismSteps":["Docetaxel freezes the microtubule scaffold so cells cannot divide","Oxaliplatin crosslinks DNA","5-FU with leucovorin blocks thymidine synthesis","Three mechanisms at once shrink the tumour before surgery and mop up microscopic disease after"],"dosing":{"route":"Intravenous","schedule":"Docetaxel 50 mg/m², oxaliplatin 85 mg/m², leucovorin 200 mg/m², 5-FU 2,600 mg/m² over 24 h, every 14 days; 4 cycles pre- and 4 post-operative","modifications":"G-CSF support commonly used; reduce for neuropathy or neutropenic fever","monitoring":"Blood counts, neuropathy, nutrition"},"toxicity":[{"event":"Neutropenia","note":"Common, including febrile neutropenia"},{"event":"Peripheral neuropathy"},{"event":"Diarrhoea, mucositis"},{"event":"Fatigue"}],"access":[],"regulatoryEvents":[]},"route":"/drugs/flot/","neighbours":{"drug":[{"id":"folfox","kind":"drug","name":"FOLFOX (5-FU, leucovorin, oxaliplatin)","route":"/drugs/folfox/"}],"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"gastric-her2-positive","kind":"cancer","name":"HER2-positive gastric cancer","route":"/cancers/gastric-her2-positive/"},{"id":"gastric-msi-high","kind":"cancer","name":"Microsatellite-unstable (MSI-high) gastric cancer","route":"/cancers/gastric-msi-high/"},{"id":"oesophageal-adenocarcinoma","kind":"cancer","name":"Oesophageal and junctional adenocarcinoma","route":"/cancers/oesophageal-adenocarcinoma/"},{"id":"esophageal","kind":"cancer","name":"Oesophageal cancer","route":"/cancers/esophageal/"},{"id":"gastric-pdl1-high","kind":"cancer","name":"PD-L1-high gastric cancer","route":"/cancers/gastric-pdl1-high/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"term":[{"id":"flot-term","kind":"term","name":"FLOT regimen (perioperative chemotherapy for gastric cancer)","route":"/terms/flot-term/"},{"id":"gastrectomy","kind":"term","name":"Gastrectomy","route":"/terms/gastrectomy/"},{"id":"gej","kind":"term","name":"Gastro-oesophageal junction (GEJ)","route":"/terms/gej/"}],"trial":[{"id":"nct06428409","kind":"trial","name":"A Clinical Study of MK-2870 Alone or With Other Treatments to Treat Gastrointestinal Cancers (MK-9999-02A)","route":"/trials/nct06428409/"},{"id":"nct07474727","kind":"trial","name":"A Phase II Study of AMT-676 Combination Therapies in Advanced Colorectal Cancer","route":"/trials/nct07474727/"},{"id":"nct05382442","kind":"trial","name":"A Study of AK112 With or Without AK117 in Metastatic Colorectal Cancer","route":"/trials/nct05382442/"},{"id":"nct05379595","kind":"trial","name":"A Study of Amivantamab Monotherapy and in Addition to Standard-of-Care Chemotherapy in Participants With Advanced or Metastatic Colorectal Cancer","route":"/trials/nct05379595/"},{"id":"nct07678593","kind":"trial","name":"A Study of GFH276 Combined With Cetuximab or Chemotherapy in Participants With Solid Tumors and Pancreatic Ductal Adenocarcinoma (PDAC) Harboring RAS Mutation","route":"/trials/nct07678593/"},{"id":"nct07805551","kind":"trial","name":"A Study of HDM2017 Combination Therapy in Advanced Colorectal Cancer","route":"/trials/nct07805551/"},{"id":"nct06792695","kind":"trial","name":"A Study of Novel Study Interventions and Combinations in Participants With Colorectal Cancer","route":"/trials/nct06792695/"},{"id":"nct07803783","kind":"trial","name":"A Study to Compare the Efficacy and Safety of YL201 With Standard Chemotherapy in Patients With Metastatic Pancreatic Cancer After Failure of Gemcitabine-Based","route":"/trials/nct07803783/"},{"id":"nct06598007","kind":"trial","name":"A Study to Determine the Effect of CT3001 in Patients With Advanced Solid Tumors","route":"/trials/nct06598007/"},{"id":"nct06820463","kind":"trial","name":"A Study to Evaluate the Adverse Events, and Efficacy of Intravenous (IV) of Telisotuzumab Adizutecan in Combination With IV Oxaliplatin, Fluorouracil,","route":"/trials/nct06820463/"},{"id":"nct06948448","kind":"trial","name":"A Study to Evaluate the Safety and Efficacy of Two Dose Levels of ONO-4578 With Opdivo®, in Combination With mFOLFOX6 and Bevacizumab Versus Standard ","route":"/trials/nct06948448/"},{"id":"nct06943820","kind":"trial","name":"AK129 Combination Therapy for Advanced Solid Tumors","route":"/trials/nct06943820/"},{"id":"nct06219941","kind":"trial","name":"AZD0901 in Participants With Advanced Solid Tumours Expressing Claudin18.2","route":"/trials/nct06219941/"},{"id":"nct04421820","kind":"trial","name":"BOLD-100 in Combination With FOLFOX for the Treatment of Advanced Solid Tumours","route":"/trials/nct04421820/"},{"id":"nct05919264","kind":"trial","name":"FOG-001 in Locally Advanced or Metastatic Solid Tumors","route":"/trials/nct05919264/"},{"id":"nct06897644","kind":"trial","name":"Gemcitabine Plus Nab-paclitaxel as Switch Maintenance Versus Continuation of Modified FOLFIRINOX as 1st Line Chemotherapy in Patients With Advanced Pancreatic C","route":"/trials/nct06897644/"},{"id":"nct04083599","kind":"trial","name":"GEN1042 Safety Trial and Anti-tumor Activity in Participants With Malignant Solid Tumors","route":"/trials/nct04083599/"},{"id":"nct07432295","kind":"trial","name":"Givastomig Combined With Nivolumab and Chemotherapy in Adults With CLDN18.2 Positive Metastatic Gastric Cancer (GIVA-2)","route":"/trials/nct07432295/"},{"id":"nct07790510","kind":"trial","name":"HSK42360-Na Tablets Combined With Cetuximab With or Without Chemotherapy in BRAF V600-Mutant Metastatic Colorectal Cancer","route":"/trials/nct07790510/"},{"id":"nct07542002","kind":"trial","name":"Liposomal Irinotecan, 5-fluorouracil/Calcium Folinate, Oxaliplatin, and Adebrelimab in Combination With Radiotherapy for Resectable or Borderline Resectable Pan","route":"/trials/nct07542002/"},{"id":"matterhorn","kind":"trial","name":"MATTERHORN","route":"/trials/matterhorn/"},{"id":"nct06370754","kind":"trial","name":"Newly Emerging Immunotherapy for Pancreatic Cancer Treatment","route":"/trials/nct06370754/"},{"id":"nct07028424","kind":"trial","name":"PANORAMIX : Optimizing 1st-line NALIRIFOX and Exploring Microbiota's Role in 2nd Line Pancreatic Cancer Treatment","route":"/trials/nct07028424/"},{"id":"nct07228832","kind":"trial","name":"Phase III Study of Ivonescimab or Bevacizumab Combined With FOLFOX in Patients With Metastatic Colorectal Cancer","route":"/trials/nct07228832/"},{"id":"nct07748611","kind":"trial","name":"SMAD4 Tailored Neoadjuvant Therapy for the Treatment of Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma, SMART-PANC Trial","route":"/trials/nct07748611/"},{"id":"nct06259058","kind":"trial","name":"Stereotactic Body Radiation Therapy Followed by NALIRIFOX vs NALIRIFOX for Borderline Resectable Pancreatic Cancer","route":"/trials/nct06259058/"},{"id":"nct07775287","kind":"trial","name":"Study of Petosemtamab Plus Chemotherapy Versus Cetuximab or Bevacizumab Plus Chemotherapy in RAS and BRAF Wild Type, Recurrent, Unresectable or Metast","route":"/trials/nct07775287/"},{"id":"nct06535607","kind":"trial","name":"Study of Volrustomig as Monotherapy or in Combination With Anti- Cancer Agents in Participants With Advanced/Metastatic Solid Tumors","route":"/trials/nct06535607/"},{"id":"nct07621718","kind":"trial","name":"Study of Zoldonrasib + Chemo of Investigator's Choice vs Placebo + Chemo of Investigator's Choice as First-line Treatment in Metastatic KRAS G12D-muta","route":"/trials/nct07621718/"},{"id":"nct06998940","kind":"trial","name":"Studying Chemotherapy With or Without Panitumumab for Unresectable, Locally Advanced, or Metastatic Pancreatic Cancer Without KRAS Mutations","route":"/trials/nct06998940/"},{"id":"nct04430738","kind":"trial","name":"Tucatinib Plus Trastuzumab and Oxaliplatin-based Chemotherapy or Pembrolizumab-containing Combinations for HER2+ Gastrointestinal Cancers","route":"/trials/nct04430738/"},{"id":"nct03977233","kind":"trial","name":"Tumor Subtypes in Subjects on FOLFIRINOX With Non-Metastatic Pancreatic Cancer","route":"/trials/nct03977233/"}]}}