title: A pilot trial of FLOT neoadjuvant chemotherapy for resectable esophagogastric junction adenocarcinoma.
abstract: Docetaxel is active in esophagogastric junction (EGJ) adenocarcinoma, and DCF (docetaxel/cisplatin/5-fluorouracil) has shown good results in the neoadjuvant setting. Its high rate of grade 3-4 mucosal toxicity (stomatitis and diarrhea) has limited its widespread adoption. A more recent docetaxel-based triplet, FLOT (5-fluorouracil, oxaliplatin and docetaxel) may be better tolerated. We conducted a pilot study of FLOT chemotherapy in EGJ adenocarcinoma patients and dysphagia to prospectively assess the rate of grade 3-4 mucosal toxicity and of pathological complete response (pCR) rate. Dysphagia and quality of life were measured with validated questionnaires. Ten patients were enrolled. Grade 3-4 mucosal toxicity rate was 0 %; pCR rate was 11 %; and near-complete pathological response rate 11 %. Dysphagia improvement or resolution was seen in 90 % of patients, and quality of life was stable before and after chemotherapy. FLOT is a safe and active neoadjuvant chemotherapy option for EGJ adenocarcinoma and should be compared to other standard regimens in randomized trials.
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada.|King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Fakeeh
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada.|Department of Surgery, McGill University, Montreal, Canada.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ferri
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Nasser
authors.initials: N
authors.lastname: Mulla
authors.affiliation: Cedars Cancer Centre, McGill University Health Centre, 1650 Boulevard Décarie, room D02-7518, Montreal, QC, H4A 3J1, Canada.|Department of Pharmacy, McGill University Health Centre, Montreal, Canada.
authors.forename: Tonia
authors.initials: T
authors.lastname: Doerksen
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Ruzug
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Santos
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada. thierry.alcindor@mcgill.ca.|Department of Medicine, McGill University, Montreal, Canada. thierry.alcindor@mcgill.ca.|Cedars Cancer Centre, McGill University Health Centre, 1650 Boulevard Décarie, room D02-7518, Montreal, QC, H4A 3J1, Canada. thierry.alcindor@mcgill.ca.
authors.forename: Thierry
authors.initials: T
authors.lastname: Alcindor
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D004943:Esophagogastric Junction / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D010865:Pilot Projects; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000188:drug therapy; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D000077143:Docetaxel; D002955:Leucovorin; D005472:Fluorouracil
keywords: Adenocarcinoma; Chemotherapy; Esophagogastric; Neoadjuvant