Comparing two chemotherapy regimens for gastric cancer treatment

Perioperative Chemotherapy With FOLFIRINOX Regimen or FLOT Regimen for Resectable Gastric or Esophagogastric Junction Adenocarcinoma (Type II-III): Open-label Randomized Phase 2/3 Trial

Phase2; Phase3 Interventional Blokhin's Russian Cancer Research Center · NCT04393584

This study is testing which of two chemotherapy combinations helps people with stomach or esophagogastric junction cancer live longer after surgery.

Quick facts

PhasePhase2; Phase3
Study typeInterventional
Enrollment538 (estimated)
Ages18 Years to 70 Years
SexAll
SponsorBlokhin's Russian Cancer Research Center Academic / other
Drugs / interventionschemotherapy, radiation
Locations1 site (Moscow)
Trial IDNCT04393584 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the effectiveness of two chemotherapy combinations, FLOT and FOLFIRINOX, in patients with resectable adenocarcinoma of the stomach or esophagogastric junction. A total of 538 participants will be randomly assigned to receive either treatment before and after surgery. The primary goal is to assess median overall survival rates among the two groups. Patients will undergo restaging of their tumor status after the initial treatment cycles to determine the next steps in their care.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18-70 with histologically confirmed resectable adenocarcinoma of the stomach or esophagogastric junction.

Not a fit: Patients with distant metastases or those who have received prior chemotherapy or radiation therapy will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could improve survival rates for patients with resectable gastric cancer.

How similar studies have performed: Previous studies have shown promising results with similar chemotherapy regimens, indicating potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. сT4 cN0 or cT1-4 cN+ histologically proven adenocarcinoma of the esophagogastric junction (Siewert type II-III) or the stomach without distant metastases (M0)
2. No previous cytostatic chemotherapy or radiation therapy
3. Age 18-70 years (female and male)
4. Eastern Cooperative Oncology Group ≤ 2
5. Surgical resectability
6. Neutrophils\> 2.000/µl
7. Platelets \> 100.000/µl
8. Normal value of Serum Creatinin
9. Albumin level \> 29 г/л
10. Aspartate transaminase (AST) or alanine transaminase (ALT) less than 3 times the upper limits of normal (ULN)
11. Total Bilirubin less than 1.5 times the ULN
12. Written informed consent.

Exclusion Criteria:

1. Previous cytostatic chemotherapy or radiation therapy
2. Distant metastases or all primarily not resectable stages
3. Cancer relapse
4. Complicated gastric cancer (perforation, bleeding, sub or decompensated stenosis, dysphagia IV)
5. Diarrhea ≥ 2 according to the criteria of Common Terminology Criteria for Adverse Events (CTCAE) version 4.1;
6. Hypersensitivity against 5- Fluorouracil, Leucovorin, Oxaliplatin, Epirubicin and Docetaxel
7. Existence of contraindications against 5- Fluorouracil, Leucovorin, Oxaliplatin, Irinotecan or Docetaxel
8. Active coronary heart disease, Cardiomyopathy or cardiac insufficiency stage III-IV according to New York Heart Association (NYHA)
9. Severe non-surgical accompanying disease or acute infection (uncontrolled arterial hypertension, diabetes mellitus, stroke less than 6 months old, mental disorders, other tumors and others)
10. Malignant secondary disease, dated back \< 5 years (exception: In-situ-carcinoma of the cervix uteri, adequately treated skin basal cell carcinoma)
11. Peripheral polyneuropathy \> Grad II
12. Liver dysfunction (AST)/ALT\>3,0xULN, ALT\>3xULN, Bilirubin\>1,5xULN)
13. Serum Creatinin \>1,0xULN
14. Chronic inflammable gastro-intestinal disease
15. Inclusion in another clinical trial
16. Pregnancy or lactation
17. Hepatitis B or C in the active stage
18. Human immunodeficiency virus(HIV) infected
19. Serious concomitant somatic and mental illnesses / deviations or territorial causes that may prevent the patient from participating in the protocol and observing the protocol schedule
20. Foreigners or persons with limited legal status

Where this trial is running

Moscow

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Stomach NeoplasmsGastrointestinal NeoplasmsDocetaxelOxaliplatinFluoruracilIrinotecan Hydrochloridegastric cancerpathological complete
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.