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FLOT4 showed that a docetaxel-based chemotherapy given before and after surgery helped people with operable stomach and junction cancers live longer than the older epirubicin-based regimen, and FLOT became the standard perioperative treatment in Europe.
The German FLOT4-AIO trial randomised 716 patients with resectable adenocarcinoma of the stomach or gastro-oesophageal junction (clinical stage T2 or higher, or node-positive) to four cycles before and four after surgery of FLOT (fluorouracil, leucovorin, oxaliplatin and docetaxel) or three cycles before and after of ECF or ECX (epirubicin, cisplatin, and fluorouracil or capecitabine), the regimen established by the MAGIC trial. The phase 2 part compared pathological response; the phase 3 primary endpoint was overall survival.
FLOT increased the rate of complete or near-complete pathological regression and lengthened overall survival compared with ECF or ECX, with a similar rate of surgical complications. It replaced the anthracycline triplet as the perioperative standard in Europe and is the backbone that ESOPEC, MATTERHORN and other trials have since built on.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
716 enrolled.
Shares Oesophageal and junctional adenocarcinoma, Leucovorin (folinic acid), Oxaliplatin, Fluorouracil (5-FU) and the tag subtype-trials.
Shares Oxaliplatin, Fluorouracil (5-FU), Capecitabine, Cisplatin and the tag subtype-trials.
Shares Fluorouracil (5-FU), Capecitabine, Cisplatin, Gastric & gastro-oesophageal junction cancer and the tag subtype-trials.
Shares Fluorouracil (5-FU), Docetaxel, Cisplatin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Leucovorin (folinic acid), Oxaliplatin, Fluorouracil (5-FU), Cytotoxic chemotherapy and the tag subtype-trials.
Shares Docetaxel, Gastric & gastro-oesophageal junction cancer and the tag subtype-trials.
Shares Cisplatin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Cisplatin, Cytotoxic chemotherapy and the tag subtype-trials.