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BackgroundPeritoneal metastasis (PM) develop in more than 50 % of gastric cancer (GC) patients. Median survival without treatment is not more than 3–7 months, and 8–12 months after modern combination chemotherapy. Innovative therapeutic approaches are urgently needed.MethodsPhase-2, open label prospective clinical trial assessing safety and efficacy of bidirectional chemotherapy for treating peritoneal metastasis of gastric cancer (PMGC). Treatment protocol included initial staging laparoscopy or laparotomy, 3–4 courses of systemic chemotherapy (XELOX) followed by Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) procedures every 6 weeks until progression of disease or death. Primary endpoints were overall survival and histological peritoneal regression grading score after rebiopsy.Results31 patients were included (9 men, 22 women, mean age 52 years), 24 with synchronous PM at diagnosis, 7 with metachronous PM after previous chemotherapy. Mean PCI was 13.8 (min-max 6–34). XELOX was administered in all patients and combined with 56 PIPAC procedures. Complete and partial pathological response was found in 60 % of the 15 patients eligible for tumor response assessment (4 and 5 patients, respectively). Median survival was 13 months.ConclusionsBidirectional chemotherapy combining XELOX with PIPAC with cisplatin and doxororubicin is well tolerated, can induce objective tumor regression and is associated with a promising survival in PMGC.

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Aim. The aim of the study is to examine the efficacy and safety of eribulin in HER2-negative metastatic breast cancer (BC) in Russian clinical practice. Materials and methods. The analysis included 459 patients with advanced BC from 44 federal and municipal medical clinics in Russia and received at least 2 courses of treatment with eribulin in accordance with the registered indications for drug. The average age of women was 56 years (between 29 and 81 years), 83% of patients had HER2-negative tumor subtype (49.9% - luminal BC and 33.1% - triple-negative BC) HER2-positive biological tumor subtype was registered in 17% of patients. Visceral metastases were diagnosed in 73% of patients and three-zone and multiple zone metastases were diagnosed in 41.6% of cases. The median number of prior lines of therapy in patients with disseminated disease was 2; anthracycline and taxane chemotherapy was applied in 94.3% of patients, and 38.1% of patients were recived CT plus capecitabine. Standard treatment regimen with eribulin was cotinuing (1.4 mg/m² as a 2-5-minute intravenous infusion administrated on days 1, 8 of a 21-day cycle) until disease progression, unacceptable toxic effects, or impossibility of the drug administration for any other reason. We estimated the efficacy and safety of treatment with eribulin in Russian patients with HER2-negative BC. Results. Objective response rate was achieved in 20.5% of cases, complete response rate was in 3.2%, partial - 17.3%, and the stable disease rate was marked in 52.7% of women, and in 19.7% of these cases was prolonged more than 6 months. The frequency of objective response was higher in luminal BC group compared with triple-negative BC: 23.5% vs 15.8%; tumor growth control 76.9% vs. 67.8%, respectively; p

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e15532 Background: Up to 40% of GC patients show synchronous PC at time of diagnosis and peritoneal relapse develops in 10–46% of cases after radical surgery. Systemic chemotherapy is standard method of treatment with median survival of several months. Innovative therapeutic approaches are needed to improve survival. Methods:Phase-2, open label prospective clinical trial assessing safety and efficacy of bidirectional chemotherapy for treating of gastric cancer with PC. Treatment protocol for untreated patients included initial staging laparoscopy or laparotomy, 3–4 courses of systemic chemotherapy (XELOX) followed by Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) procedures every 6 weeks until progression of disease or death. Criteria of progression included 50% and more PCI increase or distant metastases. Patients with primary or recurrent GC, who received earlier one or two lines of systemic chemotherapy, didn’t receive 4 XELOX courses before PIPAC. Primary endpoints were overall survival and histological peritoneal regression grading score after rebiopsy. Results:46 patients were included (14 men, 32 women, mean age 53.5 years), 33 patients had primary GC with PM and 13 had peritoneal relapse after surgery. 15 patients had systemic chemotherapy before inclusion to the program. About one half of patients had ascites. Mean PCI was 12.1 (min-max 3-34). Altogether, 89 PIPAC procedures were performed in the 46 patients. Complete and partial pathological response was found in 91% of the 23 patients eligible for tumor response assessment (7 and 14 patients, respectively). Median survival was 14 months and one-year overall survival was 55%. The median survival was better in patients with low PCI in compare with high PCI, but the difference was not significant. Conclusions: Bidirectional chemotherapy combining XELOX with PIPAC with cisplatin and doxorubicin can induce objective tumor regression and is associated with a promising survival in GC with PC.

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