Repeated normothermic intraperitoneal paclitaxel perfusion via videolaparoscopy (RIPPENC-VLP) combined with CAPOX for gastric cancer with positive cytology or limited peritoneal metastasis: A prospective phase II study.
Odilon de Souza Filho, Reinaldo Rondinelli, Antônio Carlos Accetta et al.
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In 30 seconds
This prospective, single-centre phase II study evaluated repeated normothermic intraperitoneal paclitaxel perfusion via videolaparoscopy plus systemic CAPOX in patients with gastric adenocarcinoma and positive peritoneal cytology and/or low-volume peritoneal metastases (PCI ≤10). Among 35 patients, cytological conversion from positive to negative occurred in 27 (77.1%); all converted patients underwent secondary gastrectomy. Median overall survival for the cohort was 24.7 months. The findings suggest this response-adapted approach was feasible in the selected population, while the study design does not establish comparative benefit.
Key findings
- Cytological conversion occurred in 27 of 35 patients (77.1%).
- All patients with cytological conversion underwent secondary gastrectomy.
- Median overall survival for the entire cohort was 24.7 months.
- The 35 patients underwent 95 intraperitoneal procedures, averaging 2.7 cycles per patient.
Why it matters
Positive peritoneal cytology or peritoneal metastases often preclude surgery in gastric cancer. These results indicate that, in selected patients with low-volume disease, combining intraperitoneal and systemic chemotherapy with serial response assessment may identify patients who can proceed to gastrectomy. The findings also support further evaluation of free peritoneal tumor-cell monitoring as a marker of locoregional response.
What to keep in mind
This was a single-centre phase II study without a comparator group, so it cannot establish whether the strategy improves survival or outcomes relative to other approaches.