ESMO Asia Congress 2022

Abstract 96P

Background

Flot (5-fluorouracil, leucovorin, oxaliplatin and docetaxel) is the standard regimen for perioperative chemotherapy in locally advanced gastric cancer. Preoperative chemotherapy downstages the tumor, increases pathological response. Patients receiving flot are hospitalised for more than a day. This study compares it with dox (docetaxel, oxaliplatin and capecitabine) - a daycare regimen, as capecitabine has already been proven non-inferior to 5-fluorouracil in advanced gastric cancer.

Methods

62 patients were enrolled in this prospective observational study. 31 patients received 4 doses of 2 weekly infusions of 5-fluorouracil- 2600 mg/m², leucovorin - 200 mg/m², oxaliplatin - 85 mg/m², docetaxel- 50 mg/m² on day 1. Rest 31 received 3 doses of 3 weekly infusions of docetaxel- 60 mg/m², oxaliplatin - 130 mg/m² on day 1 and tablet capecitabine -1000 mg/m² bid for 14 days. Radiological response to chemotherapy were analysed 2 weeks after chemotherapy completion and categorised into stable disease, partial response, progressive disease and complete response according to recist criteria version 1.1. Chi-square test was applied for analysis.

Results

In flot arm, 38.1 % (8) had partial response, 66.7 % (12) had progressive disease, 55 % (11) had stable disease radiologically. In dox arm, 61.9 %(13) had partial response, 33.3 % (6) had progressive disease, 45 % (9) had stable disease radiologically . 3 patients in dox regimen did not have evaluation (1 lost to follow-up; 2 died during the course of treatment). P value obtained was 0.197. The radiological response to chemotherapy was not statistically significant between two groups.

Conclusions

The radiological response to chemotherapy post flot or dox regimen is not statistically different. Dox maybe considered as an alternative regimen to flot in neoadjuvant chemotherapy in locally advanced gastric cancer patients with the advantage being a daycare procedure, requiring less resources and manpower.