Given the results of ESOPEC from ASCO 2024, for which patients with resectable esophageal adenocarcinoma would you favor neoadjuvant chemoradiation?

ESOPEC compared perioperative FLOT vs neoadjuvant chemoradiation per the CROSS trial, and showed superior OS with perioperative FLOT. What concerns do you have, if any, about offering perioperative FLOT en lieu of neoadjuvant chemoradiation? ASCO Daily News Summary

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Is perioperative FLOT the new standard for operable esophageal adenocarcinoma?

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3 Answers

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Radiation Oncology · Ohio State University James Cancer Hospital and Solove Research Institute

Answered on · Updated on

It is a great question and something that I think all of us are still wrestling to digest and readjust our treatment algorithm for patients with esophageal cancer. First, I think Dr. @Dr. First Last did an outstanding job putting ESOPEC in context in the esophageal cancer treatment landscape. In add...

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Medical Oncology · Montefiore Einstein Comprehensive Cancer Center

Answered on

I do think we have to prioritize systemic therapy with at least 2-4 cycles of FOLFOX or FLOT (distant mets kill patients). If the consensus is that R0 resection is not achievable, then following that with CRT would be reasonable to improve locoregional control. Enrolling in induction chemo-->nCRT tr...

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Radiation Oncology · Mayo Clinic

Answered on

Dr. @Dr. First Last has a great X thread summarizing ESOPEC in the context of past trials with esophageal adenocarcinoma! Check it out.

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