HER 2–positive, >= clinical tumor 2 or clinical nodal–positive resectable EGA
Four pre and postoperative cycles of either FLOT alone (N:41) or combined with trastuzumab and pertuzumab, followed by nine cycles of trastuzumab/pertuzumab (N:40)
Efficacy
pCR rate: 12% vs 35%; P:0.02
Pathologic lymph node negativity: 39% vs 68%
R0 resection rate: 90% vs 93%
mDFS: 26 m vs NR (HR: 0.58; P:0.14)
24 months DFS:54% vs 70%, OS:77% vs 84%
Safety
Grade >= 3 diarrhea 5% vs 41% and leukopenia 13% vs 23%
