Perioperative chemo with certain chemotherapy drugs ups survival in resectable esophageal cancer

For patients with resectable esophageal adenocarcinoma, perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) leads to improved survival compared with preoperative chemoradiotherapy, according to a study published in the Jan. 23 issue of the New England Journal of Medicine.

Jens Hoeppner, M.D., from Bielefeld University in Detmold, Germany, and colleagues conducted a phase 3 multicenter trial involving patients with resectable esophageal adenocarcinoma who were randomly assigned to receive perioperative chemotherapy with FLOT plus surgery or preoperative chemoradiotherapy (radiotherapy at a dose of 41.4 Gy and carboplatin and paclitaxel) plus surgery (221 and 217 patients, respectively). Eligibility criteria included a primary tumor with clinical stage cT1 cN+, cT2-4a cN+, or cT2-4a cN0 disease. The primary end point was overall survival.

The researchers found that overall survival at three years was 57.4 and 50.7% in the FLOT and preoperative-chemoradiotherapy groups, respectively, with a median follow-up of 55 months (hazard ratio for death, 0.70). At three years, progression-free survival was 51.6 and 35.0% in the FLOT and preoperative-chemoradiotherapy groups, respectively (hazard ratio for disease progression or death, 0.66). Among the patients who started the assigned treatment, grade 3 or higher adverse events occurred in 58.0 and 50.0% of those in the FLOT and preoperative-chemoradiotherapy groups, respectively.

“The current trial showed superior overall survival with FLOT as compared with preoperative chemoradiotherapy, with a median overall survival of 66 and 37 months, respectively,” the authors write.

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For patients with resectable esophageal adenocarcinoma, perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) leads to improved survival compared with preoperative chemoradiotherapy, according to a study published in the Jan. 23 issue of the New England Journal of Medicine.

Jens Hoeppner, M.D., from Bielefeld University in Detmold, Germany, and colleagues conducted a phase 3 multicenter trial involving patients with resectable esophageal adenocarcinoma who were randomly assigned to receive perioperative chemotherapy with FLOT plus surgery or preoperative chemoradiotherapy (radiotherapy at a dose of 41.4 Gy and carboplatin and paclitaxel) plus surgery (221 and 217 patients, respectively). Eligibility criteria included a primary tumor with clinical stage cT1 cN+, cT2-4a cN+, or cT2-4a cN0 disease. The primary end point was overall survival.

The researchers found that overall survival at three years was 57.4 and 50.7% in the FLOT and preoperative-chemoradiotherapy groups, respectively, with a median follow-up of 55 months (hazard ratio for death, 0.70). At three years, progression-free survival was 51.6 and 35.0% in the FLOT and preoperative-chemoradiotherapy groups, respectively (hazard ratio for disease progression or death, 0.66). Among the patients who started the assigned treatment, grade 3 or higher adverse events occurred in 58.0 and 50.0% of those in the FLOT and preoperative-chemoradiotherapy groups, respectively.

“The current trial showed superior overall survival with FLOT as compared with preoperative chemoradiotherapy, with a median overall survival of 66 and 37 months, respectively,” the authors write.

© 2025 HealthDay. All rights reserved.