Abstract 1405P
Background
FLOT regimen has been considered for early satage gastric and gastroesophageal junction (GEJ) adenocarcinoma for perioperative treatment because of its more tolerability and better response rates in metastatic disease and significant overall survival (OS) and disease free survival (DFS) advantage to ECF regimen. We aimed to determine the real-life efficacy and safety of perioperative FLOT regimen in gastric and GEJ cancer patients.
Methods
The patients with gastric and GEJ tumor who were treated with perioperative FLOT chemotherapy were retrospectively analyzed. The data of the patients collected from 38 different oncology centers in Turkey. All patients who started FLOT chemotherapy as neoadjuvant therapy were included in the study.
Results
441 patients data were analyzed in the study. The median age of the group was 60 years. The percentages of the disease-subtype according to tumor location were 46,3% for GEJ, 26,3% corpus, 24% antrum, 3,4% fundus. Of the 338 patients with radiological staging information, 0.9% were cT1-2N0, 4.7% cT1-2N(+), 4.4% cT3-4N0 and 89.9% cT3-4N(+). After median 13.5 months (IQR: 8.5-20.5) follow-up the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Median treatment of FLOT chemotherapy before surgery was 4 cycles (range: 1-12) at neoadjuvant and 4 (range: 0-8) cycles. While 93.7% of the patients could undergo surgery, the R0 resection rate was 86.6% in the data available (n=402). 6.3% of patients could not undergo surgery. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. The major recurrence site was peritoneal carcinomatosis (52.5%). At least one adverse event reported in 57.6% of the patients and grade 3-4 toxicity was seen in 23.6% patients. The most common side effect was neutropenia (26.1% any grade, 11.8% grade 3-4).
Conclusions
In our study, mOS was not reached and DFS was 22.9 months. OS at 2 years was 62% and ≤ypT1 was 26.3%. We demonstrated that pCR is a predictor of improved OS and DFS. The tolerability and safety profile of the FLOT were favorable.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.