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Perioperative chemotherapy with docetaxel, oxaliplatin, fluorouracil and leucovorin (FLOT) lengthened survival compared with the older anthracycline-based regimen in operable stomach and junctional cancers, making FLOT the standard in Europe.
Phase 2/3 trial of 716 patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (stage cT2 or higher or node-positive) randomised to perioperative FLOT (four cycles before and after surgery) or ECF/ECX (three cycles before and after).
Median overall survival was 50 versus 35 months (hazard ratio 0.77), five-year survival 45 versus 36 percent, and complete resection rates were higher with FLOT; toxicity profiles differed but were manageable.
FLOT is the reference perioperative regimen for gastric and junctional adenocarcinoma, and the backbone onto which durvalumab was added in MATTERHORN.
Shares Peter Thuss-Patience, HER2-positive gastric cancer, Docetaxel.
Shares Salah-Eddin Al-Batran, FLOT4-AIO.
Shares HER2-positive gastric cancer, Oxaliplatin, Capecitabine, Cisplatin.
Shares Oxaliplatin, The Lancet, Capecitabine.
Shares Epirubicin, Docetaxel, Capecitabine.
Shares HER2-positive gastric cancer, Oxaliplatin, Capecitabine.
Shares Epirubicin, Docetaxel, Cisplatin.
Shares PD-L1-high gastric cancer, Oxaliplatin, Capecitabine.