Background and rationale
Gastric cancer, cancer deaths, cancer, gastric cancer
GASTRIC CANCER, CANCER, GASTRIC CANCER
Gastric cancer is the fifth most common cancer and fourth leading cause of cancer deaths worldwide in 2020 [Efficacy of normothermic intraperitoneal chemotherapy (NIPEC) combined with systemic chemotherapy to treat gastric cancer PC has been extensively studied in Asia [Due to the inherent biologic differences in gastric cancer between eastern and western countries, the treatment strategy of paclitaxel NIPEC with systemic chemotherapy backbone needs to be tested in a clinical trial setting in gastric PC in the western population.Long-term survivors with stage IV gastric PC after CRS/HIPEC are well described. However, all randomized available data to date have failed to consistently show a survival benefit in gastric PC using IP chemotherapy and/or CRS/HIPEC in unselected all comer populations. Hence, this is likely due to lack of appropriate patient selection, and possibly also due to a lack of adequate conversion therapy in the induction phase. If there is strong signal favoring paclitaxel NIPEC therapy, this approach has the potential to be considered as one of the treatment arms in a future large, randomized, multi-institutional trial.