Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Elisa Giommoni , Ferdinando De Vita , Irene Pecora , Francesco Iachetta , Antonia Strippoli , Maria Antonietta Satolli , Andrea Spallanzani , Marco Puzzoni , Silvia Stragliotto , Michele Sisani , Vincenzo Formica , Filippo Giovanardi , Carmelo Pozzo , Michele Prisciandaro , Samantha Di Donato , Angelica Petrillo , Silvia Catanese , Giuseppe Tirino , Daniele Lavacchi , Lorenzo Antonuzzo
Background: Perioperative treatments have significantly improved survival in patients with resectable gastric cancer, increasing 5-year overall survival from 23% with surgery alone to 45% with FLOT (fluorouracil, oxaliplatin, docetaxel). Pathological regression is a prognostic marker of better survival. Methods: In this observational, retro- and prospective study we collected data from patients with resectable gastric or gastro-oesophageal junction (GEJ) adenocarcinoma treated, as clinical practice, with perioperative FLOT. All patients had clinical T2 or higher and/or nodal involvement, according to FLOT4-AIO trial. Results: A total of 206 patients received perioperative chemotherapy with FLOT at 15 Italian centres, between September 2016 and September 2019. Overall, 186 (90.3%) patients completed the preoperative phase, 190 (92%) underwent surgery, and 142 (68.9%) started the postoperative phase. Among patients who started the postoperative phase, 105 (51.0%) received FLOT, while 37 (18%) received less intensive regimens (e.g. FOLFOX or De Gramont), depending on performance status after surgery or toxicity in the preoperative phase. Pathological complete response (pCR) was obtained in 7.3% of cases. In the preoperative phase, grade (G) 3-4 hematological and gastrointestinal adverse events (AEs) were reported in 42 (20.4%) and 13 (6.3%) patients, respectively. Conclusions: These real data confirmed the feasibility of perioperative FLOT in a less-selected population, representative of the clinical practice. The pCR rate was lower than in the FLOT4-AIO trial. The survival outcomes, potential predictive or prognostic factors and comprehensive safety data will be included in the final analysis.
Charateristics | Patients (n = 206) |
---|---|
Sex | |
Male | 141 (68%) |
Female | 65 (32%) |
Location | |
Gastric | 114 (55%) |
GEJ | 92 (45%) |
cT | |
T3-4 | 180 (87%) |
T1-2 | 26 (13%) |
cN | |
N+ | 174 (85%) |
N0 | 32 (15%) |
Compliance | |
Completed preoperative phase | 186 (90%) |
Started postoperative phase | 142 (69%) |
Received 4 courses of postoperative FLOT without dose reduction | 29 (14%) |
Pathological response | |
ypN0 | 60 (29%) |
ypCR | 15 (7.3%) |
AEs in preoperative phase | |
Hematological G3-4 | 42 (20.4%) |
Gastrointestinal G3-4 | 13 (6.3%) |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Yelena Y. Janjigian
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Anant Ramaswamy
2023 ASCO Annual Meeting
First Author: Yoon-Koo Kang
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Yun Song