Onco Wiki / Regimen

FLOT

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

ComponentsDRUG-DOCETAXEL DRUG-OXALIPLATIN DRUG-LEUCOVORIN DRUG-5-FLUOROURACIL
IDREG-FLOT
TypeRegimen
Statusreviewed 2026-05-07 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-ESMO-GASTRIC-2024 SRC-FLOT4-AL-BATRAN-2019 SRC-NCCN-GASTRIC-2025

Notes

FLOT (docetaxel 50 + oxaliplatin 85 + leucovorin 200 + 5-FU 2600 CIV/24h q14d) per FLOT4-AIO trial (Al-Batran 2019, Lancet) — global standard perioperative regimen for resectable gastric / GEJ adenocarcinoma cT2-N+ / locally advanced. Used 4 cycles pre-op + 4 cycles post-op (8 total) in periop sequence; pairs with D2 gastrectomy. Median OS 50 vs 35 mo (HR 0.77; 95% CI 0.63-0.94) vs ECF/ECX. NCCN/ESMO category 1. Toxicity profile is significantly heavier than FOLFOX — taxane component adds neutropenia, alopecia, fluid retention, and ~20-25% febrile-neutropenia risk requiring G-CSF primary prophylaxis. FLOT4 excluded ECOG ≥2 patients; clinical fitness assessment is mandatory before initiation. For patients unfit for taxane-containing periop chemotherapy, alternative perioperative regimens (e.g., FOLFOX-based) may be considered after MDT discussion — out of C1 scope. RENAISSANCE/AIO-FLOT5 trial (Al-Batran 2024) examined adding immune checkpoint inhibition to perioperative FLOT in oligometastatic gastric; not yet a standard-of-care indication and not covered here.

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