Gastric Cancer Clinical Trial
Official title:
Phase II Multicentric Exploratory Single Cohort Clinical Trial to Assess Efficacy and Safety on a New Treatment Scheme by Systemic and Peritoneal Chemotherapy Plus Cytoreduction and HIPEC Plus Adjuvant Treatment in Patients With Peritoneal Carcinomatosis From Gastric Cancer
Implementation of a curative strategy of treatment in peritoneal carcinomatosis of gastric
cancer. The goal is to get 1C level of evidence (patient died with "standard" treatment,
with this treatment some of them survive) in terms of disease free survival and overall
survival.
Methodology: prospective, phase II, multicentric in Spain. Recruitment of 50 patients(to
have 31 on treatment) in three years. This strategy is based on neoadjuvant systemic plus
simultaneous intraperitoneal and intravenous chemotherapy(NIPS),to treat peritoneal disease
by bi-directional approach; next step is cytoreductive surgery and HIPEC. Once patients are
discharged, they will follow a systemic adjuvant chemotherapy protocol.
Patients with peritoneal carcinomatosis with gastric cancer who meet all inclusion
criteria(and none of exclusion) will follow the next treatment scheme(40 week period of
treatment):
Phase I (after one week of peritoneal catheter implant; total treatment 5-8 weeks):
intraperitoneal infusion of Docetaxel(30 mg/m2) and Cisplatin (30mg/m2) in 1000 cc of
saline. Intravenous administration 5-FU (200 mg/m2/Day, 7 days a week for 2 weeks)
simultaneously with 2 cycles of Intraperitoneal administration.
These patients receive between four and six cycles of NIPS. Until phase II 4-6 weeks.
Phase II:cytoreduction (CR) plus HIPEC (total treatment 4 weeks). Maximal efforts to optimum
cytoreduction.
HIPEC: intraperitoneal administration: Mytomicin C (15mg/m2)plus Adriamycin (15mg/m2) at
42-43ºC for 60 minutes.
Intravenous simultaneously administration 5-FU (400mg/m2) plus Leucovorin (20mg/m2) for 10
minutes at the beginning of peritoneal perfusion.
Phase III: adjuvant chemotherapy 8-12 weeks after surgery. Those cases reaching optimum
cytoreduction (CC0) will be treated with systemic chemotherapy: First day: Docetaxel (75
mg/m2) Cisplatin (75mg/m2). Days 1-5: 5-FU (750mg/m2/d).
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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