Treatment of peritoneal carcinomatosis with Paclitaxel-loaded microparticles

Phase I Trial of Intraperitoneal Paclitaxel-loaded Tumor Penetrating Microparticles (TPM) for Treatment of Peritoneal Carcinomatosis

This study is testing a new treatment using special particles loaded with a cancer drug to help patients with peritoneal carcinomatosis who don’t have other treatment options.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: University of Iowa (Academic / other)
• Drugs / interventions: chemotherapy
• Locations: 1 site (Iowa City, Iowa)
• Trial ID: NCT05159050 on ClinicalTrials.gov

What this trial studies

This is a first-in-human, phase I trial evaluating the safety and efficacy of Paclitaxel-loaded tumor penetrating microparticles (TPM) in patients with peritoneal carcinomatosis who lack standard treatment options. Participants will undergo laparoscopy for tumor biopsy and catheter placement, followed by the administration of intraperitoneal TPM. The study will monitor treatment-related toxicity and response, with pharmacokinetics assessed through blood and peritoneal fluid samples. The trial employs a dose escalation design to determine the optimal dosage while ensuring patient safety.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 to 75 with pathology-proven peritoneal carcinomatosis and no other treatment options.

Not a fit: Patients with peritoneal carcinomatosis who have viable standard treatment options or those without pathology evidence of peritoneal metastasis will not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with peritoneal carcinomatosis who currently have no available standard treatments.

How similar studies have performed: While this approach is novel, similar studies using localized drug delivery methods have shown promise in treating other cancers.

Eligibility criteria

Inclusion Criteria:

* Ability to understand and the willingness to sign a written informed consent document
* Have pathology proven peritoneal carcinomatosis (PC) due to colorectal, ovarian, gastric, pancreatic, appendiceal cancer or mesothelioma, or suspected peritoneal metastasis based on radiological findings. (Patient to come off study if no pathology evidence of peritoneal metastasis at the time of surgery)
* No other standard treatment options are available
* Measurable intraperitoneal disease by RECIST v1.1 criteria , or by radiological PCI scoring when RECIST is not feasible, on imaging studies
* 18 to 75 years of age
* Have an ECOG performance of 0 to 2
* Have adequate organ and bone marrow functions as indicated by:
* Leukocytes ≥ 3000/mcL
* Absolute neutrophil count ≥ 1500/mcL
* Platelets ≥ 100000/mcL
* Total bilirubin within normal institutional limits
* AST (SGOT) \< 3 x institutional upper limit of normal
* ALT (SPGT) \< 3 x institutional upper limit of normal
* Medically fit for surgery. Defined as: Patients who are able to undergo general anesthesia for abdominal surgery and have a metabolic equivalent (METs) ≥ 4
* Have adequate contraception, as follows:

  1. Women of child-bearing potential and men with partners of child-bearing potential 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 10 months beyond the last dose of TPM. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
  2. A woman of child-bearing potential is any female (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
* has not undergone a hysterectomy or bilateral oophorectomy; or
* has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)

  c. Men with partners of child bearing potential must use barrier contraceptive

  d. Men of child-bearing potential must not donate sperm while on this study and for 7 months after the last dose of TPM

Acceptable forms of birth control are listed below:

* One Barrier method (cervical cap with spermicide plus male condom; diaphragm with spermicide plus male condom) OR
* Hormonal method (oral contraceptives, implants, or injections) or an intrauterine device (e.g., Copper-T)

Exclusion Criteria:

* Presence of mucinous ascites
* Evidence of extra-peritoneal metastases
* Current or expected use of other investigational agents
* Received systemic chemotherapy or radiotherapy within 3 weeks prior to study enrollment or not recovering from adverse events (e.g., recovery to ≤ Grade 1)
* Abdominal cavity deemed not accessible by treating surgeon due to prior abdominal surgery
* History of allergic reactions to paclitaxel, PLG co-polymer, mannitol, or polysorbate 80
* Uncontrolled intercurrent illness
* Currently active second malignancy other than non-melanoma skin cancer
* Pregnancy, nursing, or plans to become pregnant for the duration of study participation including 10 months beyond the last dose of TPM
* Grade 2 or higher peripheral neuropathy
* CrCL ≤ 4 mL/min
* Actively treated for other malignancy
* Patients with HIV or Hepatitis B/C requiring the use of ART agents

Where this trial is running

Iowa City, Iowa

• University of Iowa Hospitals & Clinics — Iowa City, Iowa, United States (Recruiting)

Study contacts

• Principal investigator: Carlos Chan, MD, PhD — University of Iowa
• Study coordinator: Carlos H.F. Chan, MD, PhD

Conditions Peritoneal Carcinomatosis