Abstract 5908
Background
Gastric and GEJ cancers are one of the top four cancers in India with poor 5-year survival. Post ASCO 2017, we switched to docetaxel-based peri-operative chemotherapy (FLOT) which is the new standard of care. In this audit, we report the pathological response and toxicity of FLOT compared to our older standard (EOX/ECF).
Methods
We analysed our database of 118 patients with gastric or GEJ adenocarcinoma treated at our center from May 2011 to April 2019. 85 patients (72%) received perioperative chemotherapy with three pre-operative and three post-operative 3-week cycles of either EOX (50mg/m2 Epirubicin and 130mg/m2 Oxaliplatin on Day 1 plus 1250mg/m2 Capecitabine for 21 days) or ECF (50mg/m2 Epirubicin and 60mg/m2 Cisplatin on Day 1 plus 800mg/m2/day Fluorouracil as continuous intravenous infusion for 5 days). 33 patients (28%) received four pre-operative and four post-operative 2-week cycles of intravenous FLOT (50mg/m2 Docetaxel, 85mg/m2 Oxaliplatin, 200mg/m2 Leucovorin and 2600mg/m2 Fluorouracil as 24hr infusion on Day 1). We compared the toxicity, and pathological tumor response rates of patients on EOX/ECF and FLOT regimens.
Results
The patients were aged 30 to 73 years (Median 58 years) and 40 (34%) were women. 85 patients received either EOX/ECF and 33 received FLOT chemotherapy. 64 (75%) patients in EOX/ECF underwent gastrectomy among whom eight (12.5%) had pathological Tumour Regression Score (TRS) of 0 or 1. 24 (72%) patients in FLOT group have undergone gastrectomy of whom six (25%) had TRS of 0 or 1. 34 (40%) patients completed full EOX/ECF regimen while 20 (60%) completed full FLOT. The commonest reason for not completing the peri-operative chemotherapy was toxicity in EOX/ECF group (29%) and refusal to undergo surgery (21%) in the FLOT group. 15% patients did not complete FLOT chemotherapy due to toxicity.
Conclusions
FLOT regimen is a better tolerated perioperative therapy in Indian patients achieving higher pathological response compared to EOX/ECF regimen. The patients in both groups are currently on follow up to capture the relapse free survival duration.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Tanuj Chawla.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3034 - Efficacy and safety of neoadjuvant chemotherapy plus trastuzumab and pertuzumab in non-metastatic HER2-positive breast cancer in real life: NEOPEARL STUDY
Presenter: Maria Agnese Fabbri
Session: Poster Display session 2
Resources:
Abstract
4772 - Real world comparison of the impact of adjuvant capecitabine in women with high-risk triple-negative breast cancer after neoadjuvant chemotherapy
Presenter: Maysa Vilbert
Session: Poster Display session 2
Resources:
Abstract
5627 - Influence of age on the indication of adjuvant chemotherapy in early breast cancer using Oncotype DX. An analysis of 240 patients treated in the Institut Catala d’Oncologia (ICO) hospitals
Presenter: Sabela Recalde
Session: Poster Display session 2
Resources:
Abstract
3917 - Impact of delayed neoadjuvant systemic chemotherapy on survival among breast cancer patients
Presenter: Mariana Chavez Mac Gregor
Session: Poster Display session 2
Resources:
Abstract
2246 - Clinical Confirmation of Higher Exposure to Niraparib in Tumor vs Plasma in Patients With Breast Cancer
Presenter: Laura Spring
Session: Poster Display session 2
Resources:
Abstract
581 - The rationale for the effectiveness of systemic treatment of breast cancer depending on the body weight index
Presenter: Mohammad Hojouj
Session: Poster Display session 2
Resources:
Abstract
5327 - Response to neoadjuvant chemotherapy in HER2 non-overexpressing breast cancer subtypes
Presenter: Silvia Mihaela Ilie
Session: Poster Display session 2
Resources:
Abstract
3613 - Pre-specified interim analysis of the SAFE trial (NCT2236806): a 4-arm randomized, double-blind, controlled study evaluating the efficacy and safety of cardiotoxicity prevention in non-metastatic breast cancer patients treated with anthracyclines with or without trastuzumab.
Presenter: Lorenzo Livi
Session: Poster Display session 2
Resources:
Abstract
3736 - Safety of hypofractionated whole breast irradiation after conservative surgery for patients aged less than 60 years: a multi-center comparative study.
Presenter: Icro Meattini
Session: Poster Display session 2
Resources:
Abstract
5085 - Usefulness of NT-ProBNP as a biomarker of cardiotoxicity in breast cancer patients treated with trastuzumab
Presenter: Isabel Blancas López-Barajas
Session: Poster Display session 2
Resources:
Abstract