scholarly journals Systemic Chemotherapy Including Ramucirumab in Combination With Pressurized Intra-Peritoneal Aerosol Chemotherapy Is a Safe Treatment Option for Peritoneal Metastasis of Gastric Cancer

2021 ◽  
Vol 10 ◽  
Author(s):  
Linda Feldbrügge ◽  
Felix Gronau ◽  
Andreas Brandl ◽  
Timo Alexander Auer ◽  
Alan Oeff ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systemic Therapy ◽  
Peritoneal Metastasis ◽  
Systemic Chemotherapy ◽  
Postoperative Morbidity ◽  
Laparoscopic Technique ◽  
Complication Rates ◽  
The Mean ◽  
Safe Treatment Option ◽  
Length Of Interval

BackgroundPressurized intraperitoneal aerosol chemotherapy (PIPAC) is a laparoscopic technique for local chemotherapy. It has been used for treatment of peritoneal metastasis of gastric cancer (PM GC) in combination with systemic therapy. VEGFR2 antagonist ramucirumab is a second-line therapy for GC, and has been suspected to cause wound healing disorders.MethodsThis is a retrospective single center cohort study of patients with PM GC, who received PIPAC treatment in combination with systemic chemotherapy with and without ramucirumab. Data on patients’ characteristics and their perioperative courses were collected and complication rates were compared with regard to preoperative use of ramucirumab and time between last dose of systemic therapy and PIPAC treatment.ResultsFifty patients underwent 90 PIPAC treatments for PM GC in 3 years. Overall postoperative morbidity was 11% with 6% severe complications. The mean interval between systemic therapy and PIPAC was 20 days. Neither the length of interval nor the use of ramucirumab had an effect on complication rates.ConclusionOur study suggests that addition of ramucirumab to pre-PIPAC systemic therapy, irrespective of the length of the treatment-free interval before PIPAC, does not increase the risk of postoperative complications and is therefore a safe option for treatment of PM GC.

Bidirectional Systemic Chemotherapy and Pressurized Aerosol Chemotherapy (PIPAC) for Peritoneal Metastasis from Gastric Cancer

2020 ◽  
Vol 46 (2) ◽  
pp. e139
Author(s):  
Andrea Di Giorgio ◽  
Stefano Rotolo ◽  
Carlo Abatini ◽  
Miriam Attalla El Halabieh ◽  
Antonia Strippoli ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Metastasis ◽  
Systemic Chemotherapy

scholarly journals Intraperitoneal and Systemic Chemotherapy for Patients with Gastric Cancer with Peritoneal Metastasis: A Phase II Trial

2018 ◽  
Vol 38 (10) ◽  
pp. 5975-5981 ◽  
Author(s):  
MASAYUKI SHINKAI ◽  
MOTOHIRO IMANO ◽  
YASUTAKA CHIBA ◽  
YOKO HIRAKI ◽  
HIROAKI KATO ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Phase Ii ◽  
Peritoneal Metastasis ◽  
Systemic Chemotherapy ◽  
Phase Ii Trial

scholarly journals Effects of neoadjuvant laparoscopic hyperthermic intraperitoneal chemoperfusion and intraperitoneal/systemic chemotherapy on peritoneal metastasis from gastric cancer

2017 ◽  
Author(s):  
Yutaka Yonemura ◽  
Emel Canbay ◽  
Takuji Fujita ◽  
Shouszou Sako ◽  
Satoshi Wakama ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Metastasis ◽  
Systemic Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Postoperative Mortality ◽  
Port Placement ◽  
Positive Cytology ◽  
Peritoneal Cancer ◽  
Intraperitoneal Chemoperfusion ◽  
Exploratory Laparoscopy

Our aim was to clarify the effects of neoadjuvant hyperthermic intraperitoneal chemoperfusion (NLHIPEC) followed by intraperitoneal/systemic chemotherapy (NIPS) on peritoneal metastasis from gastric cancer. After carrying out exploratory laparoscopy to determine the peritoneal cancer index (pretreatment PCI: Pre-PCI) in 150 patients, we performed NLHIPEC for 60 min. with peritoneal port placement: a series of 3-week cycles of NIPS using S1, docetaxel, and cisplatin two weeks after NLHIPEC: performed cytoreductive surgery in 86 patients four weeks after NIPS, and subsequently measured PCI (Post-PCI). Positive cytology in 38 patients changed to negative in 26 (68.4%) patients at laparotomy. The post-PCI (6.7±7.8) was significantly lower than the pre-PCI (10.6±10.2) (P=0.0001). The PCI was ≥14 in 30 patients at pretreatment and ≤13 in 19 (63.3􀀁) of these patients at posttreatmjent. Post-PCI cut-off level (≤13 vs ≥14) and cytology after NIPS (negative vs positive) emerged as independent indicators of prognosis. Postoperative mortality was 1.2% (1/86). NLHIPEC and NIPS are safe and effective modalities for reducing Post-PCI below the cut-off level and eradicating peritoneal free cancer cells.

scholarly journals Neoadjuvant systemic and hyperthermic intraperitoneal chemotherapy combined with cytoreductive surgery for gastric cancer patients with limited peritoneal metastasis: a prospective cohort study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pengfei Yu ◽  
Zeyao Ye ◽  
Gaiguo Dai ◽  
Yanqiang Zhang ◽  
Ling Huang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Intraperitoneal Chemotherapy ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Systemic Chemotherapy ◽  
Palliative Chemotherapy ◽  
Therapy Group ◽  
Conversion Therapy ◽  
Gastric Cancer Patients

Abstract Background There is no currently available treatment for peritoneal metastasis of gastric cancer. This phase II study aimed to evaluate the efficacy and safety of neoadjuvant systemic chemotherapy and hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery (CRS) for the treatment of these patients. Methods Neoadjuvant chemotherapy comprised two cycles of HIPEC and four cycles of S-1 plus paclitaxel. HIPEC was administered intraperitoneally with paclitaxel (75 mg/m2). For systemic chemotherapy, paclitaxel was administered intravenously(150 mg/m2) on day 1, and S-1 was administered orally(80 mg/m2/day)on days 1–14 of a 3-week cycle. Another two cycles of HIPEC and four cycles of S-1 plus paclitaxel were administered after second diagnostic staging laparoscopy or CRS. The primary endpoints were treatment efficiency and safety; the secondary endpoint was 3-year overall survival (OS). Results A total of 40 patients were enrolled and 38 patients have been analyzed. Of these, 18 (47.4%) patients received neoadjuvant systemic chemotherapy, HIPEC and CRS (conversion therapy group), while 20 patients received only chemotherapy and HIPEC (palliative chemotherapy group). Median OS was markedly improved in the conversion therapy group (21.1 months, 95% confidence interval [CI] 16.7–25.6 months) in comparison with the palliative chemotherapy group(10.8 months, 95%CI 7.3–14.2 months, p = 0.002). After neoadjuvant systemic chemotherapy and HIPEC, a second laparoscopic exploration was performed, and the prognosis of patients with low peritoneal cancer index (PCI) (PCI < 6) was significantly better than that of patients with high PCI (PCI ≥ 6)(20.1 vs.11.3 months, p = 0.006). Conclusion Neoadjuvant systemic chemotherapy and HIPEC combined with CRS is safe and feasible, and could potentially improve the prognosis of gastric cancer patients with limited peritoneal metastasis. However, further clinical trials are still warranted. Trial registration This study has been registered with ClinicalTrials.gov as NCT02549911. Trial registration date: 15/09/2015.

Phase II Study of Single Intraperitoneal Chemotherapy Followed by Systemic Chemotherapy for Gastric Cancer with Peritoneal Metastasis

2012 ◽  
Vol 16 (12) ◽  
pp. 2190-2196 ◽  
Author(s):  
Motohiro Imano ◽  
Atsushi Yasuda ◽  
Tatsuki Itoh ◽  
Takao Satou ◽  
Ying-Feng Peng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Phase Ii ◽  
Intraperitoneal Chemotherapy ◽  
Peritoneal Metastasis ◽  
Systemic Chemotherapy ◽  
Phase Ii Study
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