Neoadjuvant chemotherapy with FOLFIRINOX regimen for resectable gastric cancer: immediate results

Objective. To compare the immediate efficiency and tolerability of the perioperative FLOT regimen and the neoadjuvant FOLFIRINOX. Subjects and methods. The control retrospective group received 4 cycles of chemotherapy with FLOT regimen before surgery and 4 cycles after surgery. The study group used all 8 cycles of chemotherapy with FOLFIRINOX regimen at the preoperative stage. The degree of therapeutic pathomorphism was assessed using the scales designed by K. Becker, A.M. Mandard, and G.A. Lavnikova. Results. The rate of complete tumor regression was higher in the FLOT group (n=59) than in the FOLFIRINOX group (n=60). In the study group, the rate of complete and partial pathomorphisms was higher in the presence of the diffuse subtype. In the FOLFIRINOX group, there were 73.3% of the patients who had received all chemotherapy cycles while 71.2% were in the FLOT group. The frequency of dose reductions was equal: in the FLOT and FOLFIRINOX groups, there were 22.1 and 21.7%, respectively; moreover, drug discontinuation in the FLOT group was seen more frequently (8.5% versus 5%). Conclusion. The investigation demonstrated the acceptable toxicity profile of the neoadjuvant FOLFIRINOX regimen and the number of patients (73.3%) who had received the entire scope of treatment. The incidence of polyneuropathy and hepatotoxicity was higher in the FLOT group (52.6% versus 31.7% and 50.9% versus 26.7%, respectively). Complete and partial polymorphisms was more often recorded in the FLOT group (grade 1a—1b after Becker, grade 1—2 after Mandard, and grade 3—4 after Lavnikova (the FLOT group showed 47.7, 40.5, and 54.8%, respectively) (the FOLFIRINOX group had 47.7, 40.5, and 54.8%, respectively). © 2023, Media Sphera Publishing Group. All rights reserved.