FLOT refers to a type of chemotherapy treatment available as a four-drug combination. It may be suitable for individuals with certain cancers, such as stomach cancer. Doctors administer FLOT via a drip and a pump, and treatment takes place in a hospital setting.

Chemotherapy is a treatment option that involves drugs that kill rapidly dividing cancer cells and prevents them from growing and making more cells. Many different types of chemotherapy drugs are available, and they may have different effects on different cancers. FLOT receives its name after the drugs in the treatment regimen.

This article explores the drugs involved in FLOT therapy, expectations, and side effects, among other factors.

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FLOT refers to four chemotherapy drugs:

It may be a good treatment option for stomach and esophageal cancers. The drugs destroy cancer cells that are dividing at a fast rate.


Fluorouracil, also known as 5FU, is often given in combination with other cancer drugs. It is an antimetabolite drug, which means it kills cancer cells by acting as false building blocks in the cell’s genes so that it dies before dividing. A person takes fluorouracil intravenously usually via a small pump.


Unlike the other three drugs, leucovorin is not a chemotherapy drug. It is an active metabolite of folic acid that improves fluorouracil’s effectiveness. It is also known as folinic acid. A person receives leucovorin intravenously through a drip.


Oxaliplatin, also known as Eloxatin, is an alkylating agent. This means that it interferes with the development of DNA in a cell, preventing it from dividing into new cells. Doctors often use this drug in combination with other chemotherapy drugs. A person also receives oxaliplatin through a drip and sometimes at the same time as leucovorin.


Docetaxel is an antineoplastic agent, which means it contains chemicals that kill rapidly dividing cells, such as cancer cells. A person can also receive docetaxel by a drip into a vein.

Before or on the day of treatment, a healthcare professional will take a blood sample to check that the individual is a suitable candidate for chemotherapy. Often, a person will also receive antinausea, or antiemetic drugs, before starting chemotherapy.

Individuals receive FLOT treatment intravenously. A healthcare professional performs this treatment using a long plastic tube that they insert into the vein in the chest. The FLOT treatment cycle requires 8 cycles, each lasting 14 days. A person receives the first four cycles before surgery and the next four cycles after surgery. The schedule typically runs as below:

by drip into a veinaround 4 hours
1fluorouracilby a pump slowly through a vein1 day (24 hours)
2disconnect pumpabout 30 minutes

FLOT chemotherapy is a common drug combination for stomach cancer. Similarly, research suggests it is also an effective treatment option for esophageal cancer.

A 2021 retrospective analysis notes that overall survival was higher for individuals that completed their FLOT regimen to treat cancer. This emphasizes the importance of chemotherapy and receiving the maximum number of cycles. Additionally, a 2019 analysis and a 2021 review article suggest that using FLOT chemotherapy can help to improve overall survival.

Learn how to know whether chemo is working or not.

While cancer treatments intend to destroy cancer cells, they can also damage normal cells in the body, which can result in side effects. It is likely that anyone receiving chemotherapy will experience some side effects, and some people will have more issues than others. Some common side effects that people may experience when receiving treatment with FLOT include:

Fluorouracil side effects and risks

Side effects of fluorouracil may include:

Leucovorin side effects and risks

Leucovorin rarely causes side effects as it is not a chemotherapy drug. In rare cases, it may cause:

Oxaliplatin side effects and risks

Individuals who take oxaliplatin may experience the following:

Docetaxel side effects and risks

As with the other drugs in FLOT, docetaxel can cause side effects, which can include:

  • hematologic complications
  • fever
  • swelling
  • alopecia

FLOT is a chemotherapy drug combination that a doctor may use to treat cancer. Often, they may use it for stomach and esophageal cancer. FLOT involves four drugs from which it receives its name: fluorouracil, leucovorin, oxaliplatin, and docetaxel.

Individuals receive this type of treatment intravenously at a hospital or outpatient cancer center. A healthcare professional will administer these drugs using a drip and a pump.

The FLOT treatment cycle typically requires 8 cycles, each lasting 2 weeks. As with other types of chemotherapy, side effects may occur, such as fever, nausea, fatigue, and alopecia.