Multicenter phase 3 trial of first-line TFOX versus FOLFOX for advanced HER2-negative gastric or gastro-esophageal junction adenocarcinoma

The multicenter phase 3 GASTFOX trial in France compared first-line modified FLOT/TFOX (docetaxel, folinic acid and oxaliplatin then 5-fluorouracil as a continuous 46 hour infusion every two weeks; n=254) versus first-line FOLFOX (n=253) for advanced HER2-negative gastric or gastro-esophageal junction adenocarcinoma in patients with ECOG performance status 0 or 1. The modified FLOT/TFOX regimen significantly improved progression-free survival, overall survival, and objective response rate compared with FOLFOX. The authors conclude that the modified FLOT/TFOX regimen might represent a new first-line treatment option for patients eligible for this docetaxel triplet chemotherapy.