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P-91 Safety and efficacy of perioperative FLOT in elderly patients: Real-world data

2021; Elsevier BV; Volume: 32; Linguagem: Inglês

10.1016/j.annonc.2021.05.146

1569-8041

Mafalda Miranda Baleiras, T. Tomás, Joana Mendonça, Teresa Padrão, Marco Dinis, M. Pinto, Ana Paula Martins,

Esophageal and GI Pathology

Locally advanced gastric and gastroesophageal junction (LAG/JEG) is the third leading cause of cancer-related mortality worldwide. FLOT (fluorouracil plus leucovorin, oxaliplatin and docetaxel) perioperative chemotherapy is the gold standard treatment for LAG/JEG cancer. The elderly population is usually underrepresented in clinical trials, thus causing scarcity in available data to study the safety of this regimen among seniors. Hence, we aimed to assess in a real-world setting the safety and efficacy of FLOT in elderly patients. We conducted a retrospective, multicentre, observational study including patients diagnosed with LAG/JEG cancer treated with FLOT between July 2016 and March 2020 in five Lisbon hospitals. Patients were stratified according to age: ≥65 (A group) and < 65 (B group) years old. Data were collected from patient medical records and analysed with IBM SPSS v25.0. A total of 144 patients were included. The median age was 65 years (30-84) and 50.7% of patients enrolled (n=73) were ≥65 years. Within the A-group, 50 individuals (68.5%) completed preoperative chemotherapy, 65 (89%) underwent surgery and 42 out of the 54 (78%) that were assigned to postoperative phase received four cycles of chemotherapy. No significant differences between the two groups were found in R0 ressection and pathological complete response (pCR) rates. A significantly higher rate of dose reduction was reported in elderly patients (71.4% vs. 28.6%; p=0.001). However, no significant differences were found in either treatment delay (50% in both; p=0.906) or treatment suspension (A: 62.5%, B: 37.5%; p=0.316). The incidence of grade 3-4 adverse events was similar across the two groups. Nevertheless, a significantly higher rate of grade 3-4 diarrhea (79.6% vs. 23.1%; p=0.037) and grade 3-4 peripheral neuropathy (80% vs. 20%; p=0.044) was reported in younger patients. There were two treatment-related deaths, one in each group. The mean progression-free survival (PFS) was 2.6 and 2.8 months in A and B, respectively (95%IC: 1.948-3.178, p=0.145), while the mean overall survival (OS) was 28.6 and 36.3 months (95%IC: 25.019-39.707, p=0.090). Perioperative FLOT is safe in elderly patients. A careful dose adjustment may be required to better manage toxicities in these subjects. Dose reductions in this context do not seem to weaken treatment efficacy. Deeper studies are desirable to establish the robustness of these results.