Does docetaxel matter in metastatic gastric cancer? FOLFOX versus FLOT regimens as first-line treatment

Anticancer Drugs. 2022 Jan 1;33(1):e477-e485. doi: 10.1097/CAD.0000000000001143.

Abstract

We aimed to compare the efficacy and the safety of the FOLFOX and the FLOT regimens in metastatic gastric cancer (mGC) as first-line treatment. It was a retrospective multicenter observational study. The comparisons between groups were conducted in terms of progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and hematologic adverse events. Seventy-nine patients, diagnosed with mGC between March 2012 and December 2019, treated with FOLFOX (n = 43) or FLOT (n = 36) regimens as first-line treatment were included in the study. The mPFS was 10.9 months [95% confidence interval (CI), 5.8-16.1] in the FLOT arm and 7.1 months (95% CI, 5.1-9.1) in the FOLFOX arm (P < 0.001). The ORR was 63.9% in the FLOT arm and 30.2% in the FOLFOX arm (P = 0.003). The mOS was 13.3 months (95% CI, 11.3-15.4) in the FLOT arm and 10.9 months (95% CI, 8.2-13.5) in the FOLFOX arm (P = 0.103). The hematologic adverse events in all grades were 88.4% (n = 38) in the FOLFOX arm compared with 80.6% (n = 29) in the FLOT arm (P = 0.335). The FLOT regimen might be a preferred option in mGC with an improved PFS and ORR compared with the FOLFOX regimen.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Docetaxel / administration & dosage
  • Docetaxel / adverse effects
  • Docetaxel / therapeutic use*
  • Esophagogastric Junction / pathology
  • Female
  • Fluorouracil / therapeutic use
  • Hematologic Diseases / chemically induced
  • Humans
  • Leucovorin / therapeutic use
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin / therapeutic use
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Survival Analysis

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Docetaxel
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol