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This combination therapy, often referred to as FLOT-Serplulimab, is a perioperative regimen being evaluated for the treatment of locally advanced gastric adenocarcinoma. It combines the standard-of-care FLOT chemotherapy (fluorouracil, leucovorin, oxaliplatin, and docetaxel) with serplulimab, a recombinant humanized anti-PD-1 monoclonal antibody. Serplulimab works by blocking the interaction between PD-1 on T cells and its ligands (PD-L1 and PD-L2), thereby revitalizing the immune system's ability to recognize and destroy tumor cells. The chemotherapy components provide direct cytotoxic effects: docetaxel stabilizes microtubules to inhibit mitosis, oxaliplatin forms DNA cross-links to induce apoptosis, and fluorouracil (potentiated by leucovorin) inhibits thymidylate synthase to disrupt DNA synthesis. This multi-modal approach is designed to maximize pathological complete response (pCR) rates in stage III, PD-L1 positive patients.
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