#4577 RENAL SAFETY OF FLOT REGIMEN FOR GASTROESOPHAGEAL CANCER

Abstract

Abstract Background and Aims Currently, peri-operative docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil (FLOT) chemotherapy is the gold standard treatment for patients with locally advanced gastric cancer (LAGC), who undergo peri-operative chemotherapy and surgery. The known nephrotoxicity of both docetaxel and oxaliplatin compounds may limit the its application in CKD population. Nevertheless, limited evidence is available regarding the effects of FLOT regimen on renal function. In our analysis we evaluated the renal safety of FLOT regimen in LAGC population. Method Retrospective data on patient with resectable gastric cancer in four tertiary referral hospital between jan/2018 to jan/2022 have been analyzed. Patient have been treated with docetaxel (60 mg/m2), oxaliplatin (85 mg/m2), leucovorin (200 mg/m2), and 5-fluorouracil (2,600 mg/m2 as a 24 hr infusion), all given on day 1 and administered every 2 weeks in 4 administrations before surgery. Serum creatinine, hemoglobin, lymphocytes and CKD-EPI eGFR were detected at baseline and before each cycle. AKI and CKD onset/prevalence were determined according to K-DIGO criteria. Results A consecutive cohort of 90 patients was enrolled. At baseline CKD was present in 16 pts (21.9%). Median eGFR was 84,9 ml/min. In terms of eGFR decay and CKD onset during the treatment cycle, the result of ANOVA indicated no significant differences or relationship with FLOT; Wilks’ Lambda = 0.94, p = 0.354 (Table 1 and Figure 1). AKI incidence was very low with one episode of stage 2 AKI (0,7%) between the 2nd and the 4th treatment cycle. New onset anemia between the 1st and the 2nd cycle was the only significant adverse event observed (p = 0.003). Conclusion According to our results, the pre-operative FLOT regimen seems to have a negligible impact on renal function with very low rate of renal toxicity suggesting the possibility to extend its use even in patient with advanced CKD.