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PIPAC With Nab-paclitaxel and Cisplatin in Peritoneal Carcinomatosis (Nab-PIPAC)

Primary Purpose

Peritoneal Carcinomatosis

Status
Recruiting
Phase
Phase 1
Locations
Switzerland
Study Type
Interventional
Intervention
Nab paclitaxel
Cisplatin
Sponsored by
University Hospital, Geneva
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peritoneal Carcinomatosis focused on measuring pancreatic cancer, oeso-gastric cancer, epithelial ovarian cancer, primitive peritoneal mesothelioma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  • Informed consent as documented by signature
  • ≥18 years,
  • psychologically able to follow the trial procedures
  • with peritoneal carcinomatosis from pancreatic, oesogastric, epithelial ovarian cancers or primitive peritoneal mesothelioma,
  • ECOG 0, 1 or 2,
  • Life expectancy > 3 months,
  • Not candidate for surgical cytoreduction and IP/HIPEC based on expert multidisciplinary board
  • who received at least one line of chemotherapy and for whom standard therapies have been exhausted or not feasible. patients with residual disease following the first line of therapy or Following secondary debulking are eligible.

Exclusion criteria:

  • Predominant extra-peritoneal metastases at the discretion of the study team after discussion at the multidisciplinary board,
  • Bowel obstruction, active gastro-duodenal ulcer or ongoing abdominal infection (bacterial, viral or fungal),
  • Chemotherapy or surgery within the last two weeks prior to enrollment,
  • Previous intra-abdominal chemotherapy,
  • General or local (abdominal) contra-indications for laparoscopic surgery
  • Known allergy to cisplatin or other platinum-containing compounds or to nab-paclitaxel,
  • Severe renal impairment (calculated GFR (CKD-EPI) < 60 mL/min/1.73 m2), myelosuppression (platelet count < 100.000/μl, hemoglobin < 9g/dl, neutrophil granulocytes < 1.500/ml), International Normalized Ratio (INR) > 2, severe hepatic (Serum total bilirubin > 1.5 mg/dl), respiratory or neurologic impairment (grade 3), severe myocardial insufficiency (NYHA class > 2), recent myocardial infarction, severe arrhythmias,
  • Pregnancy or breastfeeding, women who can become pregnant must ensure effective contraception.
  • Known or suspected non-compliance, inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant,
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.

Sites / Locations

  • University Hospital, LausanneRecruiting
  • University Hospital, GenevaRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental Arm

Arm Description

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) administration of Nab paclitaxel and cisplatin

Outcomes

Primary Outcome Measures

Determine the maximal tolerated dose (MTD) of Nab paclitaxel (Abraxane®) administered IP by PIPAC in concomitance with cisplatin.
MTD is defined as the lowest dose level at which ≥33% of patients' experience dose limiting toxicity in accordance to CTCAE version 5.0 criteria.

Secondary Outcome Measures

Adverse events (AE) and serious adverse events (SAE)
AE and SAE with predefined toxicity criteria will be applied using CTCAE version 5.0 criteria, documented before and after each cycle of PIPAC treatment. Surgical complications will be assessed according to Clavien classification and comprehensive complication index (CCI)
The efficacy
It will be assessed by the objective histological regression and objective tumor response rate (OTR) according to the new regression system for peritoneal cancer (PRGS, peritoneal regression grade score system). The objective response rate (ORR), the clinical benefit rate (CBR) as defined by RECIST version 1.1 criteria and the relevance of radiological response assessed by CT enterography (CT-PCI score).
The QoL
QoL will be evaluated based on the EORTC questionnaire QLQ-C30 Version 3.0 and visual analogic scale for pain (VAS scale).

Full Information

First Posted
May 29, 2019
Last Updated
December 15, 2022
Sponsor
University Hospital, Geneva
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1. Study Identification

Unique Protocol Identification Number
NCT04000906
Brief Title
PIPAC With Nab-paclitaxel and Cisplatin in Peritoneal Carcinomatosis
Acronym
Nab-PIPAC
Official Title
A Phase Ib Trial of Intraperitoneal Cisplatin and Nab-paclitaxel Administered by Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) in the Treatment of Advanced Malignancies Confined to the Peritoneal Cavity
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 11, 2020 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Hospital, Geneva

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Phase Ib trial including investigating the combination of nab-paclitaxel and cisplatin in patients diagnosed with peritoneal carcinomatosis related to pancreatic, oeso-gastric, ovarian cancer or primitive peritoneal mesothelioma.
Detailed Description
Phase Ib trial investigating the combination of intraperitoneal Cisplatin (10.5 mg/m2) and Nab-paclitaxel (escalated dose from 7.5 mg/m2 to 70 mg/m2) administered by pressurized intraperitoneal aerosol chemotherapy (PIPAC) every 4-6 weeks for 3 cycles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peritoneal Carcinomatosis
Keywords
pancreatic cancer, oeso-gastric cancer, epithelial ovarian cancer, primitive peritoneal mesothelioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental Arm
Arm Type
Experimental
Arm Description
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) administration of Nab paclitaxel and cisplatin
Intervention Type
Drug
Intervention Name(s)
Nab paclitaxel
Intervention Description
Dose escalation (7.5 mg/m2, 15 mg/m2, 25 mg/m2, 37.5 mg/m2, 52.5 mg/m2 and 70 mg/m2)
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Description
10.5 mg/m2
Primary Outcome Measure Information:
Title
Determine the maximal tolerated dose (MTD) of Nab paclitaxel (Abraxane®) administered IP by PIPAC in concomitance with cisplatin.
Description
MTD is defined as the lowest dose level at which ≥33% of patients' experience dose limiting toxicity in accordance to CTCAE version 5.0 criteria.
Time Frame
From the time of treatment randomization through 30 days following cessation of treatment
Secondary Outcome Measure Information:
Title
Adverse events (AE) and serious adverse events (SAE)
Description
AE and SAE with predefined toxicity criteria will be applied using CTCAE version 5.0 criteria, documented before and after each cycle of PIPAC treatment. Surgical complications will be assessed according to Clavien classification and comprehensive complication index (CCI)
Time Frame
D-1/D10 of each cycle
Title
The efficacy
Description
It will be assessed by the objective histological regression and objective tumor response rate (OTR) according to the new regression system for peritoneal cancer (PRGS, peritoneal regression grade score system). The objective response rate (ORR), the clinical benefit rate (CBR) as defined by RECIST version 1.1 criteria and the relevance of radiological response assessed by CT enterography (CT-PCI score).
Time Frame
D0 of each cycle
Title
The QoL
Description
QoL will be evaluated based on the EORTC questionnaire QLQ-C30 Version 3.0 and visual analogic scale for pain (VAS scale).
Time Frame
D-1/D10 of each cycle

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Informed consent as documented by signature ≥18 years, psychologically able to follow the trial procedures with peritoneal carcinomatosis from pancreatic, oesogastric, epithelial ovarian cancers or primitive peritoneal mesothelioma, ECOG 0, 1 or 2, Life expectancy > 3 months, Not candidate for surgical cytoreduction and IP/HIPEC based on expert multidisciplinary board who received at least one line of chemotherapy and for whom standard therapies have been exhausted or not feasible. patients with residual disease following the first line of therapy or Following secondary debulking are eligible. Exclusion criteria: Predominant extra-peritoneal metastases at the discretion of the study team after discussion at the multidisciplinary board, Bowel obstruction, active gastro-duodenal ulcer or ongoing abdominal infection (bacterial, viral or fungal), Chemotherapy or surgery within the last two weeks prior to enrollment, Previous intra-abdominal chemotherapy, General or local (abdominal) contra-indications for laparoscopic surgery Known allergy to cisplatin or other platinum-containing compounds or to nab-paclitaxel, Severe renal impairment (calculated GFR (CKD-EPI) < 60 mL/min/1.73 m2), myelosuppression (platelet count < 100.000/μl, hemoglobin < 9g/dl, neutrophil granulocytes < 1.500/ml), International Normalized Ratio (INR) > 2, severe hepatic (Serum total bilirubin > 1.5 mg/dl), respiratory or neurologic impairment (grade 3), severe myocardial insufficiency (NYHA class > 2), recent myocardial infarction, severe arrhythmias, Pregnancy or breastfeeding, women who can become pregnant must ensure effective contraception. Known or suspected non-compliance, inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant, Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Intidhar Labidi-Galy, MD, PhD
Phone
0041 22 372 4014
Email
intidhar.labidi-galy@hcuge.ch
First Name & Middle Initial & Last Name or Official Title & Degree
Catherine Raimond, PharmD
Phone
0041 22 37 22 908
Email
catherine.raimond@hcuge.ch
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Intidhar Labidi-Galy, MD, PhD
Organizational Affiliation
University Hospital, Geneva
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital, Lausanne
City
Lausanne
State/Province
Vaud
ZIP/Postal Code
1011
Country
Switzerland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antonella Diciolla, MD
Phone
0041 79 55 63 011
Email
Antonella.Diciolla@chuv.ch
Facility Name
University Hospital, Geneva
City
Geneva
ZIP/Postal Code
1211
Country
Switzerland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Intidhar Labidi-Galy, MD, PhD
Phone
0041 22 372 4014
Email
intidhar.labidi-galy@hcuge.ch
First Name & Middle Initial & Last Name & Degree
Catherine Raimond, PharmD
Phone
0041 22 37 22 908
Email
catherine.raimond@hcuge.ch

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The only clinical data available to researchers will be anonymised. Requests may be directed to Sponsor Investigator or designee. The informed consent form and clinical study report will be made available
IPD Sharing Time Frame
Data can be shared no earlier than 1 year following the date of publication.
IPD Sharing Access Criteria
All data supporting the findings of the current study will be made available from the corresponding author upon reasonable request.

Learn more about this trial

PIPAC With Nab-paclitaxel and Cisplatin in Peritoneal Carcinomatosis

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