Pilot Study of Perioperative Docetaxel, Oxaliplatin, and 5-Fluorouracil (FLOT) in Gastroesophageal Adenocarcinoma

Data about occurrence of diarrhea and mouth sores will be recorded through the use of quality-of-life questionnaires

Inclusion criteria

• Histological diagnosis of adenocarcinoma of the stomach, gastro-esophageal junction (GEJ), or lower third of the esophagus.
• The tumor must be deemed by the team to be potentially resectable. This includes imaging studies (detailed below) to clinically stage the tumor and rule out the presence of metastatic disease, and includes a preoperative laparoscopic evaluation.
• Stage IB (T1N1 only), II, IIIA, IIIB, and IV (T4N1 only)
• Life expectancy greater than 3 months
• ECOG performance status of 0-2 (i.e. restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work).
• Adequate hematologic reserve: Platelet count greater than or equal to 100,000 microlitre, WBC greater than or equal to 2000 microlitre,
• Creatinine clearance greater than or equal to 30 ml/min, AST & ALT less than or equal to 2 ULN, Alkaline phosphatase less than or equal to 2.5 ULN, bilirubin less than or equal ULN

Exclusion criteria

• Prior systemic therapy for gastric cancer
• Prior docetaxel-containing chemotherapy
• Pre-existing medical conditions precluding treatment, including any contraindication for major surgery
• Pregnancy or lactating mothers. Women of childbearing age must use contraception during and for 3 months following treatment
• Inability to give informed consent
• Inability to maintain nutrition by oral consumption of food alone must have additional enteral feeding.
• Macroscopic disease noted at laparoscopy
• ECOG peformance status of 3 or higher
• Unwillingness to undergo investigations and/or treatment as outlined on the study