Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma

Fiteni, Frédéric; Paget‐Bailly, Sophie; Messager, Mathieu; Nguyen, Thierry; Lakkis, Zaher; Mathieu, P; Lamfichekh, Najib; Picard, Alain; Benzidane, Bilell; Cléau, D.; Bonnetain, Franck; Borg, Christophe; Mariette, C.; Kim, Stéfano

doi:10.1002/cam4.885

Cited by 16 publications

(18 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 . Most studies were based on prospective data, and only 5 studies evaluated retrospective data 9,18–21 . The chemotherapy regimens included are: FLOT: fluorouracil, oxaliplatin and docetaxel; DOS: docetaxel, oxaliplatin and S1; DCX: docetaxel, cisplatin and capecitabine; DCF: docetaxel, cisplatin and fluorouracil; FLOD: 5-Fluorodeoxyuridine, oxaliplatin and docetaxel; DCS: docetaxel, cisplatin and S1.…”

Section: Resultsmentioning

confidence: 99%

“…17 2011EasternProspective29Borrmann Type IVGastricNRDCF225NR6,951,7NR16(55)9(31)Fiteni et al . 21 2016Western EuropeRetrospective41≥T1 or N+Gastric, GEJNRDCF225NR793NR34(83)23(56)mo. : months; Lymph: lymphadenectomy; pCR: pathological complete response; R0: resection rates with no gross tumor remains in the tumor bed; PFS: Progression free survival; OS: Overall Survival; N: Number; GEJ: Gastroesophageal Junction Tumors; DE: Distal Esophagus; FLOT: fluorouracil, oxaliplatin and docetaxel; DOS: docetaxel, oxaliplatin and S1; DCX: docetaxel, cisplatin and capecitabine; DCF: docetaxel, cisplatin and fluorouracil; FLOD: 5-Fluorodeoxyuridine, oxaliplatin and docetaxel; DCS: docetaxel, cisplatin and S1; NR: Not Reported; y.: year; Siew.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review and meta-analysis of docetaxel perioperative chemotherapy regimens in gastric and esophagogastric tumors

Usón

Santos

Bugano

et al. 2019

Sci Rep

View full text Add to dashboard Cite

FLOT regimen became the standard perioperative treatment in several centers around the world for esophagogastric tumors despite concerns about toxicity. In addition, FLOT has never been compared with other docetaxel-based regimens. To address this question, we conducted a systematic review of PubMed, Embase and Web of Science including prospective or retrospective studies of docetaxel based perioperative regimen in gastric and esophagogastric tumors. Data regarding chemotherapy regimens, efficacy and toxicity were extracted. Outcomes were compared using a random effects model. Of 548 abstracts, 16 were considered eligible. Comparing the studies with meta-analysis we can see that the regimens are similar in terms of pathological complete response, resection rate, progression free survival and overall survival in one year, without significant heterogeneity. The meta-regression of docetaxel dose failed to show any association with dose ranging between 120–450 mg/m². Regarding the toxicity of the regimens it is noted that the regimens are quite toxic (up to 50–70% of grade 3–4 neutropenia). The results of this meta-analysis with a combined sample size of more than 1,000 patients suggest that docetaxel perioperative regimens are equivalent in outcomes. Prospective trials addressing modified regimens should be performed to provide less toxic strategies and be applicable to all patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Systematic review and meta-analysis of docetaxel perioperative chemotherapy regimens in gastric and esophagogastric tumors

Usón

Santos

Bugano

et al. 2019

Sci Rep

View full text Add to dashboard Cite

show abstract

“…In the large multicenter randomized controlled trial 07-FFCD 9703 in France,10 the HR was 0.69 (95% CI, 0.50–0.95) in the DCF regimen compared with the surgery alone. Fiteni et al15 conducted a large retrospective study based on the propensity score. In Fiteni’s study, the DCF regimen was compared with the surgery group, and the 5-year survival rate was 0.293 (95% CI, 0.135–0.636) in the treatment of gastroesophageal junction cancer.…”

Section: Discussionmentioning

confidence: 99%

<p>Docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil (FLOT) as preoperative and postoperative chemotherapy compared with surgery followed by chemotherapy for patients with locally advanced gastric cancer: a propensity score-based analysis</p>

Wang¹,

Ren²,

Ma³

et al. 2019

CMAR

View full text Add to dashboard Cite

Introduction: Docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil (FLOT) may improve overall survival (OS) in patients with locally advanced gastric cancer (LAGC); however, evidence for its use as a standard treatment has not been established in China. The aim of this study was to investigate the effectiveness, safety, and feasibility of the FLOT regimen as neoadjuvant chemotherapy in Chinese patients with resectable LAGC. Methods: We conducted an observational study to compare the effectiveness of FLOT regimen consisting of docetaxel (60 mg/m 2 ), oxaliplatin (85 mg/m 2 ), leucovorin (200 mg/m 2 ), and 5-fluorouracil (2,600 mg/m 2 as a 24 hr infusion), all given on day 1 and administered every 2 weeks versus initial surgery followed by chemotherapy in patients with clinical T3–4 LAGC. OS was compared by using the Cox proportional hazards regression model and the Kaplan–Meier curve adjusted by inverse probability of treatment weighting (IPTW) and propensity score-matched (PSM) analysis. In addition, we performed subgroup analyses to determine the effectiveness of the FLOT regimen in clinically relevant patient subsets. Results: Overall, 47 patients who received initial FLOT chemotherapy and 269 patients who received initial surgery were enrolled in this study. In the PSM analysis, the FLOT-first group showed favorable OS compared with the surgery-first group (41 vs 41 [HR, 0.416; 95% CI, 0.218–0.794; P =0.008]), and 3-year survival rates were 58.7% and 30.9% in the FLOT-first group and surgery-first group, respectively. IPTW analysis showed similar results. However, the effect of FLOT was low (HR, 0.868; 95 CI%, 0.215–3.504) in patients without lymph node metastasis. Conclusion: Our study suggests that preoperative FLOT chemotherapy is safe and feasible. In terms of OS, FLOT may be superior to initial surgery followed by chemotherapy in reducing morbidity with resectable LAGC.

show abstract

“…Four reports employed a prognostic analysis using IPTW to analyze the data of patients with gastric and EC (21–24). Two of those reports used PS matching and IPTW to evaluate the effects of perioperative chemotherapy in patients with gastroesophageal adenocarcinoma (23,24). Fiteni et al reported better outcomes with perioperative chemotherapy [docetaxel, cisplatin, and fluorouracil (DCF) regimen] than with surgery alone, after applying both IPTW and PS matching to the analysis.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of preoperative chemoradiotherapy for advanced esophageal cancer, evaluated by propensity score matching and weighting of inverse probability of treatment

et al. 2019

View full text Add to dashboard Cite

The present study used inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) to compare survival benefits among 112 patients with resectable, stage II–IV esophageal squamous cell carcinoma (SCC) treated between 1996 and 2016 with neoadjuvant chemoradiotherapy (NAC) plus surgery (Group A, n =55) or with surgery alone (Group B, n =57). Their propensity scores (PS) were calculated using a multivariable logistic regression model in which age, sex, cancer site, primary tumor length, cTNM stage, lymph node metastasis and depth of tumor invasion were the independent variables, and used to match Groups A and B according to the IPTW and matching method. After IPTW and PSM, univariate analysis was used to assess overall survival (OS) and disease-free survival (DFS), followed by Cox proportional hazard models for OS using IPTW between the two groups and the subgroups. After PSM, 5-year OS and DFS were significantly higher in Group A (OS: 65.2%, DFS: 65.2%) compared with Group B (OS: 31.2%, DFS: 20.87%). Similarly, after IPTW, OS and DFS were significantly higher in Group A compared with Group B patients. Five-year OS was 73.18% for Group A and 37.69% for Group B (hazard ratio: 0.2899, 95% confidence interval: 0.1167–0.7205). To conclude, treatment was more effective in Group A patients with clinical stage II, N0 and T3 disease involving the mid-esophagus. It was concluded that for patients with esophageal SCC, NAC plus esophagectomy exhibited improved survival compared with surgery alone, as demonstrated by use of IPTW and PSM methods.

show abstract

Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma

Cited by 16 publications

References 13 publications

Systematic review and meta-analysis of docetaxel perioperative chemotherapy regimens in gastric and esophagogastric tumors

Systematic review and meta-analysis of docetaxel perioperative chemotherapy regimens in gastric and esophagogastric tumors

<p>Docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil (FLOT) as preoperative and postoperative chemotherapy compared with surgery followed by chemotherapy for patients with locally advanced gastric cancer: a propensity score-based analysis</p>

Clinical significance of preoperative chemoradiotherapy for advanced esophageal cancer, evaluated by propensity score matching and weighting of inverse probability of treatment

Contact Info

Product

Resources

About