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ePoster Display

1389P - Real world outcomes of locally advanced gastric/GOJ cancers receiving perioperative chemotherapy with FLOT regimen during the COVID-19 pandemic: Results from a regional cancer care centre in the UK

Date

16 Sep 2021

Session

ePoster Display

Topics

Tumour Site

Gastric Cancer

Presenters

Subhadeep Bose

Citation

Annals of Oncology (2021) 32 (suppl_5): S1040-S1075. 10.1016/annonc/annonc708

Authors

S. Bose1, R. Chowdhary1, A. Menon1, T. Hafeez1, M. Joseph2

Author affiliations

  • 1 Medical Oncology, Deanesly Centre - New Cross Hospital - The Royal Wolverhampton NHS Trust, WV10 0QP - Wolverhampton/GB
  • 2 Clinical Oncology, Deanesly Centre - New Cross Hospital - The Royal Wolverhampton NHS Trust, WV10 0QP - Wolverhampton/GB

Resources

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Abstract 1389P

Background

In locally advanced gastroesophageal and gastric cancers, which constitute the majority of the presentation, the postoperative 5 year survival rate remains only 30-40%. It is in these patients that perioperative chemotherapy has helped improve radical resection rates control preoperative micrometastases and improve survival. Since 2017,FLOT based chemotherapy has largely replaced ECF/ECX in this setting. We did a retrospective analysis on our patients treated with FLOT regimen during the COVID-19 pandemic to assess its efficacy, tolerance and pathological response (TRG).

Methods

Patients with resectable gastric and GOJ cancers who presented to us from August 2019 – March 2020 and treated with FLOT based perioperative chemotherapy were analyzed with SPSS (version 26, IBM, Armonk, NY). Pathologic assessment of tumour regression was done by Mandard's TRG scoring. A total of 36 patients were analysed, out of which 91% were males, median age 68 years,cT3/T4 86%, cN1/2 72.2%,GOJ 77.8%,Gastric 22%,Grade 2/3 94%.Total of 80.6% patients completed all 4 cycles of neoadjuvant FLOT and 88.9% patients underwent surgery(all R0).Median interval between last dose of chemo and surgery was 7 weeks.A total of 52.8% patients completed all 4 cycles of adjuvant FLOT. Treatment was delayed due to COVID-19 in 11%.

Results

Median followup was 16.3 mths.1 year DFS was 66.3% and OS was 91.4%.Pathological CR(TRG 1) was seen in 2.8% patients.3 patients died due to postop complications. Most common grd-3 toxicities were oral mucositis(6%), diarrhea (6%),neutropenia(8.3%).5FU cardiotoxicity noted in 5.6%. Table: 1389P

TRG (Mandard) Frequency Percent
1(complete regression) 1 2.8
2(rare residual cancer cells) 4 11.1
3(increased no. of cancer cells,fibrosis still predominates) 13 36.1
4(residual cancer outgrowing fibrosis) 10 27.8
5(absence of regressive changes) 4 11.1

Conclusions

In our subset of patients,treatment delivery,surgery rates and toxicity profile were comparable to the seminal FLOT4 trial.Our histological responses are lower with pathCR in only 2.8% (vs 16%)patients,with most having TRG 3.The survival rates are better but a longer followup is required.

Clinical trial identification

n/a

Editorial acknowledgement

Nil

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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