Peri-operative triplet chemo regimens, such as FLOT, have demonstrated winning survival times when used for advanced esophagogastric cancers. The problem remains, as with so many cancer therapies, the big room for improvement in morbidity of treatment, with reported rates of associated grade 3+ toxicities as high as 90%. This single-arm phase 2 trial evaluated FOLFIRINOX among 67 patients with inoperable locally-advanced, recurrent, or metastatic esophagogastric adenocarcinoma with a prespecificed goal of achieving an objective response rate of 60%. Of these, 26 were HER2+ and received trastuzumab in conjunction with FOLFIRINOX. Only 5 had received prior chemo. In the end, the objective response rate was 61% for HER2- and 85% for HER2+ disease. TBL: FOLFIRINOX (with trastuzumab if HER2+) is poised to challenge FLOT in the next iteration of peri-op chemo for esophagogastric cancer and is hopefully better tolerated. | Park, JAMA Oncol 2020


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