Individualized Response Assessment to Heated Intraperitoneal Chemotherapy (HIPEC) for the Treatment of Peritoneal Carcinomatosis From Ovarian, Colorectal, Appendiceal, or Peritoneal Mesothelioma Histologies
Peritoneal Carcinomatosis, Peritoneal Mesothelioma, Ovarian Cancer
About this trial
This is an interventional diagnostic trial for Peritoneal Carcinomatosis focused on measuring cytoreductive surgery (CRS), SMART System, necrosis, Ki-67, Peritoneal Metastasis
Eligibility Criteria
- INCLUSION CRITERIA:
- Confirmation of peritoneal carcinomatosis from appendiceal, colorectal, ovarian, or peritoneal mesothelioma histologies by the Laboratory of Pathology, NCI.
- Measurable or evaluable disease as defined by RECIST v1.1. criteria and/or by peritoneal carcinomatosis index (PCI) score.
- Participants must be assessed to be able to undergo complete cytoreduction, with PCI score <= 30 at the time of laparoscopy.
- Age >= 18 years.
- ECOG performance status <= 1 (Karnofsky >= 80%).
Participants must have adequate organ and marrow function as defined below:
- Leukocytes >= 3,000/mcL
- Absolute neutrophil count >= 1,000/mcL
- Platelets >= 75,000/mcL
- Total bilirubin within normal institutional limits
- AST (SGOT)/ ALT (SGPT) <= 3x institutional upper limit of normal (ULN)
- Creatinine within normal institutional limits
OR
--Creatinine clearance >= 60 mL/min/1.73 M^2 for participants with creatinine levels above institutional normal calculated using eGFR.
- Because therapeutic agents used in this trial are known to be teratogenic, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for 180 days after last study treatment; should a woman suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
- Ability of participant to understand and the willingness to sign a written informed consent document.
- Ability and willingness to co-enroll on the tissue collection protocol 13C0176, Tumor, Normal Tissue and Specimens from Patients Undergoing Evaluation or Surgical Resection of Solid Tumors .
EXCLUSION CRITERIA:
- Participants with known extra-abdominal metastatic disease from the participant s appendiceal, colorectal, ovarian, or peritoneal mesothelioma primary.
- Participants who have received intraperitoneal chemotherapy or other anti-cancer therapy within the last 4 weeks prior to the start of study treatment.
- Participants who have undergone major surgery within the last 12 weeks prior to the start of study treatment.
- History of allergic reactions attributed to platinum-containing compounds.
- History of dihydropyrimidine dehydrogenase deificiency (appendiceal or colorectal
cancer patients only).
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Pregnant women are excluded from this study because the protocol involves major abdominal surgery and chemotherapeutic agents with the potential for teratogenic or abortifacient effects; because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother, breastfeeding should be discontinued if the mother is undergoing treatment.
- HIV-positive participants with detectable viral load despite antiretroviral therapy are ineligible because of participants increased risk of lethal infections when treated with marrow-suppressive therapy. HIV-positive participants who have undetectable viral load on antiretroviral therapy may be considered for this study only after consultation with a NIAID physician.
Sites / Locations
- National Institutes of Health Clinical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
1/ HIPEC: Oxaliplatin Randomized treatment assignment
2/ HIPEC: Mitomycin C Randomized treatment assignment
3/ HIPEC: Cisplatin, Doxorubicin Randomized treatment assignme
4/ HIPEC: Cisplatin, Mitomycin C Randomized treatment assignme
HIPEC with intraperitoneal oxaliplatin and IV 5-FU, randomly assigned
HIPEC with intraperitoneal mitomycin C, randomly assigned
HIPEC with intraperitoneal cisplatin and doxorubicin, in addition to IV sodium thiosulfate, randomly assigned
HIPEC with intraperitoneal cisplatin and mitomycin C, in addition to IV sodium thiosulfate, randomly assigned