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A pilot trial of FLOT neoadjuvant chemotherapy for resectable esophagogastric junction adenocarcinoma

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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.

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Authors and Affiliations

  1. Department of Oncology, McGill University, Montreal, Canada

    Ali Al-Fakeeh, Lorenzo Ferri, Nasser Mulla, Ibrahim Al-Ruzug, Fabiano Santos & Thierry Alcindor

  2. Department of Surgery, McGill University, Montreal, Canada

    Lorenzo Ferri

  3. Department of Medicine, McGill University, Montreal, Canada

    Thierry Alcindor

  4. Cedars Cancer Centre, McGill University Health Centre, 1650 Boulevard Décarie, room D02-7518, Montreal, QC, H4A 3J1, Canada

    Tonia Doerksen & Thierry Alcindor

  5. Department of Pharmacy, McGill University Health Centre, Montreal, Canada

    Tonia Doerksen

  6. King Fahad Medical City, Riyadh, Saudi Arabia

    Ali Al-Fakeeh

Authors
  1. Ali Al-Fakeeh
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  2. Lorenzo Ferri
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  3. Nasser Mulla
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  4. Tonia Doerksen
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  5. Ibrahim Al-Ruzug
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  6. Fabiano Santos
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  7. Thierry Alcindor
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Corresponding author

Correspondence to Thierry Alcindor.

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The authors declare no conflict of interests.

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Al-Fakeeh, A., Ferri, L., Mulla, N. et al. A pilot trial of FLOT neoadjuvant chemotherapy for resectable esophagogastric junction adenocarcinoma. Med Oncol 33, 62 (2016). https://doi.org/10.1007/s12032-016-0774-4

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  • DOI: https://doi.org/10.1007/s12032-016-0774-4

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