FLOT

FLOT is a chemotherapy regimen used primarily for treating stomach (gastric) and esophageal cancers. It's a combination therapy consisting of four different drugs, each contributing to its cancer-fighting effects. **Drug Information** FLOT is a combination chemotherapy regimen that includes: - **Fluorouracil (5-FU)** - A chemotherapy drug that destroys rapidly dividing cells - **Leucovorin (Folinic acid)** - A drug that enhances the effectiveness of fluorouracil - **Oxaliplatin** - A platinum-based chemotherapy drug - **Docetaxel** - A taxane-based chemotherapy drug This regimen is typically administered intravenously in cycles, with each cycle lasting 2 weeks. Patients usually receive 8 cycles in total - 4 cycles before surgery and 4 cycles after surgery for resectable gastric cancer. **Treatment Administration** FLOT is administered through a long plastic tube inserted into a large vein in the chest, which can be a central line, PICC line, or portacath. The standard dosing regimen includes: - Fluorouracil: 2,600 mg/m² as a 24-hour infusion - Leucovorin: 200 mg/m² - Oxaliplatin: 85 mg/m² - Docetaxel: 50-60 mg/m² All drugs are given on day 1 of each 14-day cycle. **Medical Uses** FLOT is primarily used for: - Stomach (gastric) cancer - Esophageal cancer - Gastroesophageal junction cancer It's commonly used in both neoadjuvant (before surgery) and adjuvant (after surgery) settings for locally advanced gastric cancer. The FLOT4-AIO trial demonstrated that FLOT improved overall survival compared to other regimens like ECF/ECX (epirubicin, cisplatin, and fluorouracil or capecitabine). **Side Effects** Common side effects of FLOT chemotherapy include: - Neutropenia and other hematologic complications - Nausea and vomiting - Fatigue - Cold-induced neuropathy (from oxaliplatin) - Fever - Alopecia (hair loss) - Sensory neuropathy (which may lead to treatment discontinuation) Before starting treatment, patients undergo DPD testing to check for gene changes that affect how the body processes fluorouracil, as DPD deficiency can lead to serious side effects. **Effectiveness** The FLOT regimen has shown significant effectiveness in clinical trials: - In the perioperative setting, it demonstrated improved progression-free survival (30 vs. 18 months) and overall survival (50 vs. 35 months) compared to ECF/ECX regimens - For metastatic gastric cancer, studies have shown objective response rates of 57.7-73.2% with median overall survival of 10.3-13.6 months FLOT has become a standard treatment option for locally advanced gastric cancer, particularly in the perioperative setting, due to its favorable efficacy profile compared to other chemotherapy combinations.

Other names

FLOT-A