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FLOT + CROSS is a total neoadjuvant therapy (TNT) regimen being evaluated by the Erasmus Medical Center for the treatment of resectable, lymph node-positive adenocarcinoma of the esophagus or esophagogastric junction. This intensive approach combines two established neoadjuvant standards: the FLOT regimen (fluorouracil, leucovorin, oxaliplatin, and docetaxel) and the CROSS regimen (carboplatin, paclitaxel, and concurrent radiotherapy). The treatment strategy involves administering both regimens sequentially before surgery to improve outcomes in high-risk patients (cN+) who typically have a poorer prognosis compared to node-negative patients. The Phase II trial (NCT05023408) specifically investigates the efficacy and feasibility of two different sequences: FLOT followed by CROSS versus CROSS followed by FLOT.
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