Abstract 1535P
Background
Peritoneal metastases (PM) represent one of the most refractory disease states. It frequently develops in patients (pts) with gastric (GC) or pancreatic (PC) cancer, significantly impacting their prognosis. Many types of systematic chemotherapies have been evaluated for PC but the results were not satisfactory. Recently, the use of intraperitoneal paclitaxel (ipPTX) plus systemic chemotherapy for GC with PM has shown promising clinical results, especially in pts who underwent conversion surgery after disappearance of PM due to ipPTX (Ishigami H, et al. J. Clin Oncol. 2018). We have studied ipPTX for GC and PC with PM since 2012. In this analysis, we focus on cases resulting in successful conversion surgery.
Methods
142 pts with GC and 34 pts with PC with PM have been treated with ipPTX since February 2012 to December 2019. Systemic chemotherapies were selected from standard regimens for GC or PC, such as DCS (docetaxel/CDDP/S-1), SP (S-1/CDDP), or FOLFORINOX, gemcitabine/nab-paclitaxel, depending on the patient’s condition. IpPTX was administered at 20mg/m2 weekly, 2-weeks or 3-weeks in a row with 1-week rest, according to the schedule of systemic regimens. Patients whose metastases were limited to peritoneum became candidates for conversion surgery.
Results
Of the 46 candidates in GC and 15 in PC, 25 and 6 cases, respectively, achieved conversion surgery after confirmed complete disappearance of PM. Progression free survival and overall survival were 20.9 months and 47.4 months in GC, and 21.8 months and not reached in PC.
Conclusions
Our retrospective analysis showed that the combination of ipPTX with systemic chemotherapy for both GC and PC with PM increases the probability of achieving conversion surgery, which in turn provides significantly better survival benefits than conventional chemotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Yasushi Tsuji.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.