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New Protocol: FLOT Versus FLOT/Trastuzumab/Pertuzumab Perioperative Therapy of HER 2–Positive Resectable Esophagogastric Adenocarcinoma

New Protocol: FLOT Versus FLOT/Trastuzumab/Pertuzumab Perioperative Therapy of HER 2–Positive Resectable Esophagogastric Adenocarcinoma
Study:
  • Multicenter, randomized phase II/III trial
  • HER 2–positive, >= clinical tumor 2 or clinical nodal–positive resectable EGA
  • Four pre and postoperative cycles of either FLOT alone (N:41) or combined with trastuzumab and pertuzumab, followed by nine cycles of trastuzumab/pertuzumab (N:40)
Efficacy:
  • pCR rate: 12% vs 35%; P:0.02
  • Pathologic lymph node negativity: 39% vs 68%
  • R0 resection rate: 90% vs 93%
  • mDFS: 26 m vs NR (HR: 0.58; P:0.14)
  • 24 months DFS:54% vs 70%, OS:77% vs 84%
Safety:
  • Grade >= 3 diarrhea 5% vs 41% and leukopenia 13% vs 23%
  • Grade 1 or 2 weight loss: 10% vs 38%

Oncol. 2022 Jun 16;JCO2200380.

Hofheinz, Ralf-Dieter et al. “FLOT Versus FLOT/Trastuzumab/Pertuzumab Perioperative Therapy of Human Epidermal Growth Factor Receptor 2-Positive Resectable Esophagogastric Adenocarcinoma: A Randomized Phase II Trial of the AIO EGA Study Group.”

https://doi.org/10.1200/jco.22.00380

Reviewed by Hasan Çağrı Yıldırım, MD on Jul 06, 2022

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