Sequential chemotherapy with intraperitoneal Paclitaxel for gastric cancer

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This phase II clinical trial evaluates the safety and efficacy of a combination of systemic and intraperitoneal chemotherapy in patients with primary gastric or gastroesophageal junction adenocarcinoma that has spread to the peritoneum. Eligible patients will receive systemic therapy for 3-4 months, followed by diagnostic laparoscopy and placement of an intraperitoneal port if they show no distant organ metastasis. The intraperitoneal regimen includes Paclitaxel, Fluorouracil, and Leucovorin, administered over several cycles. Patients will be monitored for treatment response and may undergo further interventions based on their disease status.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Patients must have histologically or cytologically confirmed primary gastric or gastroesophageal adenocarcinoma and have received a minimum of three months of first line systemic treatment without visceral metastatic progression
* Must have peritoneal cytology positive disease or peritoneal carcinomatosis detected by imaging, laparoscopy or laparotomy
* Age ≥ 18 -75 years
* Performance status: ECOG performance status ≤ 2 (Appendix A) . ECOG 2 allowed is attributed to malignancy (rather than comorbidities)
* Life expectancy of greater than 6 months
* Adequate organ and marrow function as defined below:

  1. Leukocytes: ≥ 2,000/mcL
  2. Absolute Neutrophil Count: ≥ 1,500/mcL
  3. Platelets: ≥ 80,000/mcL
  4. Total Bilirubin: within normal institutional limits
  5. AST(SGOT)/ALT(SPGT): ≤5 X institutional upper limit of normal
  6. Creatinine: \< 1.5 X institutional upper limit of normal
  7. Hemoglobin: \> 8.0 g/dL (may be transfused)
  8. Serum albumin: ≥ g/dL
* Ability to understand and the willingness to sign a written informed consent

Exclusion Criteria:

* Systemic treatment for unresectable or metastatic disease for more than three months prior to enrollment
* Any evidence of distant, solid organ metastases (visceral (liver, lung, brain), bone, extra-abdominal)
* Any evidence of extensive retroperitoneal lymph node metastases not amenable to resection during gastrectomy
* Any evidence of small or large bowel obstruction with the exception of gastric outlet obstruction due to primary malignancy
* Uncontrolled intercurrent illness including, but not limited to, the following conditions:

  1. Ongoing or active infection
  2. Symptomatic congestive heart failure
  3. Stroke (including transient ischemic attack \[TIA\]), myocardial infarction (MI), or other ischemic event,) within 3 months before initiation of treatment
  4. Unstable angina pectoris
  5. Cardiac arrhythmia
* History of another primary cancer within the last 3 years with the exception of non-melanoma skin cancer, early-stage prostate cancer, or curatively treated cervical carcinoma in-situ and not treated with systemic therapy.
* Inability to comply with study and follow-up procedures as judged by the Investigator
* Patients must not be pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants.Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
* Has an active infection requiring systemic therapy.
* Prior surgery that would preclude safe diagnostic laparoscopy and port placement
* Has a known history of active tuberculosis (TB; Bacillus tuberculosis).
* Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator

Where it's running

• Chao Family Comprehensive Cancer Center, University of California, Irvine
  Orange, California, United States Recruiting

Study contacts

• Principal investigator: Maheswari Senthil, MD — Chao Family Comprehensive Cancer Center
• Study coordinator: Chao Family Comprehensive Cancer Center University of California, Irvine
• Email: ucstudy@uci.edu
• Phone: 1-877-827-7883

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.