Intraperitoneal Chemotherapy in Gastric Cancer With Peritoneal Carcinomatosis

NCT ID: NCT05541146

Last Updated: 2023-03-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-01

Study Completion Date

2025-01-31

Brief Summary

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Peritoneal carcinomatosis (PC) in gastric cancer (GC) is considered a fatal disease, without expectation of definitive cure. Since conventional surgery is not indicated in the palliative setting, and systemic chemotherapy treatments are not sufficient to contain the disease, a multimodal approach associating intraperitoneal (IP) chemotherapy (CMT) with surgery may represent an alternative for these patients.

IP CMT has shown superior results to conventional treatment in patients at this stage of the disease, and can achieve complete regression of lesions in a significant portion of cases. Once response to treatment is achieved, patients become fit for curative surgery, which offers a new perspective on the survival in these previously unresectable cases, and raising survival rates to similar levels to patients undergoing surgery with curative intention.

Thus, the aim of this study is to evaluate the complete response rate and curative resection in patients with PC by GC at Instituto do Cancer do Estado de São Paulo (ICESP) treated with IP CMT. Patients prospectively included in the study will undergo implantation of a peritoneum catheter to perform outpatient IP CMT in order to promote the regression of lesions. Those with complete regression may be referred for surgical treatment, curing a portion of these patients. The diagnosis of PC will be performed by conventional cytological, immunohistochemical and liquid cytology methods to determine the presence of tumor cells in the peritoneal lavage and to evaluate the sensitivity of the methods. In addition, it is proposed in the study the storage of material for further study of circulating markers in peripheral blood and peritoneal lavage that may be related to response or resistance to treatment.

It is believed that IP CMT may not only increase the survival of patients with PC, but also offer the possibility of cure for a significant portion of patients who are currently without treatment prospects and with a median survival of only six months.

Detailed Description

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This is a prospective study lasting 36 months.

Conditions

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Gastric Cancer Peritoneal Carcinomatosis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Patients will undergo intraperitoneal chemotherapy with Paclitaxel (4 cycles) associated with systemic chemotherapy. After treatment, patients will be reassessed and if there is a peritoneal response, they will undergo gastrectomy.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intraperitoneal chemotherapy

Intraperitoneal chemotherapy in gastric cancer patients with peritoneal carcinomatosis.

Group Type EXPERIMENTAL

Intraperitoneal chemotherapy

Intervention Type COMBINATION_PRODUCT

Patients will undergo intraperitoneal chemotherapy with Paclitaxel (4 cycles) associated with systemic chemotherapy. After treatment, patients will be reassessed and if there is a peritoneal response, they will undergo gastrectomy

Interventions

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Intraperitoneal chemotherapy

Patients will undergo intraperitoneal chemotherapy with Paclitaxel (4 cycles) associated with systemic chemotherapy. After treatment, patients will be reassessed and if there is a peritoneal response, they will undergo gastrectomy

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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Implantation of intraperitoneal catheter for chemotherapy with Paclitaxel

Eligibility Criteria

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Inclusion Criteria

* Gastric adenocarcinoma
* Presence of peritoneal carcinomatosis documented through intraoperative identification and confirmed by biopsies and/or positive oncotic cytology;
* Presence of exclusively peritoneal metastasis with PCI \< 12;
* Age between 18 and 75 years;
* Eastern Cooperative Oncology Group (ECOG) performance scale 0 and 1;
* Body mass index (BMI) greater than 18;
* Total WBC count ≥3000, neutrophils ≥1500, hemoglobin ≥8, and platelet count ≥100,000;
* Bilirubin \<2, TGO/TGP/FA/GGT 3x the reference value;
* Creatinine clearance calculated by the Cockcroft-Gault formula ≥ 50 ml/min.

Exclusion Criteria

* Synchronous or metachronic neoplasms;
* Previous antineoplastic treatment for gastric cancer;
* Clinical conditions considered critical by the investigator;
* Obstruction of the digestive tract;
* Suspected gastrointestinal bleeding;
* New York Heart Association functional class II/III/IV heart failure;
* Heart disease that, in the opinion of the investigator, prevents the patient from receiving the necessary hydration during chemotherapy with cisplatin.
* Known HIV infection or chronic use of immunosuppressants;
* Acute myocardial infarction or stroke in the last 6 months
* pregnant.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto do Cancer do Estado de São Paulo

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andre Roncon Dias, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Instituto do Câncer de São Paulo - ICESP

Locations

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Instituto do Câncer de São Paulo - ICESP

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Andre Roncon Dias, MD, PhD

Role: CONTACT

+55 11 3893-2000

Facility Contacts

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Andre Roncon Dias, MD, PhD

Role: primary

Other Identifiers

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26306419.8.0000.0065

Identifier Type: REGISTRY

Identifier Source: secondary_id

2020/13249-0

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

NP 1507/19

Identifier Type: -

Identifier Source: org_study_id

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