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Stomach NeoplasmPhase 3PERISCOPEIINCT03348150

Gastrectomy + Cytoreductive Surgery + HIPEC for Gastric Cancer With Peritoneal Dissemination.

A Phase 3 study testing Cytoreductive surgery + Gastrecomy and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in people with Stomach Neoplasm and Peritoneal Carcinomatosis, run by The Netherlands Cancer Institute at 1 site in Netherlands.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

A randomized controlled two-armed phase III trial for gastric cancer patients with peritoneal dissemination. Randomization between gastrectomy + cytoreductive surgery + HIPEC (experimental arm) and palliative systemic chemotherapy (standard arm). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Stomach Neoplasm, Peritoneal Carcinomatosis
What is being tested?
Cytoreductive surgery + Gastrecomy and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
102 participants
Where
1 siteNetherlands
Study dates
1 Oct 2017to 1 Oct 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years
  • Biopsy proven primary adenocarcinoma (or undifferentiated carcinoma) of the stomach. Including tumours at the oesophagogastric junction provided that the bulk of the tumour is located in the stomach, and, the intended surgical treatment is a gastric resection and not an oesophagectomy. A high intra-thoracic anastomosis is allowed, but not if a thoracotomy is necessary.
  • cT3-cT4 tumour (TNM classification, 7th edition), considered to be resectable (including lymph nodes)
  • Limited peritoneal carcinomatosis (PCI <7) and/ or tumour positive peritoneal cytology confirmed by laparoscopy or laparotomy and proven by pathological examination
  • Treatment with systemic chemotherapy, with the latest course ending within 8 weeks prior to inclusion. All currently standard chemotherapy regimens are acceptable
  • Absence of disease progression during systemic chemotherapy (prior to inclusion)
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  • WHO performance status 0-2
  • Adequate bone marrow, hepatic and renal function. Minimally acceptable laboratory values at start of the study inclusion:
  • ANC ≥ 1.5 x 109 /L
  • Platelet count ≥ 100 x 109 /L
  • Serum bilirubin ≤ 1.5 x ULN, and ALAT and ASAT ≤ 2.5 x ULN
  • Creatinine clearance ≥ 50 ml/min (measured or calculated by Cockcroft-Gault formula)
  • For female patients who are not sterilised or in menopause (i.e., amenorrhea ≥1 year if age ≥60 years, or ≥2 years if age <60 years):
  • negative pregnancy test (urine/serum)
  • no breast feeding or active pregnancy ambition
  • reliable contraceptive methods
  • Signed informed consent

Who cannot join

  • Distant metastases (e.g., liver, lung, para-aortic lymph nodes; i.e., stations 14 and 16) or small bowel dissemination
  • Recurrent gastric cancer
  • Prior resection of the primary gastric tumour
  • Non-synchronous peritoneal carcinomatosis
  • Current other malignancy (other than cervix carcinoma and basalioma)
  • Uncontrolled infectious disease or known infection with Human Immunodeficiency Virus type -1 or -2
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  • A known history of hepatitis B or C with active viral replication
  • Recent myocardial infarction (< 6 months) or unstable angina
  • Any medical condition not yet specified above that is considered to interfere with study procedures, including adequate follow-up and compliance and/or would jeopardise safe treatment
  • Known hypersensitivity for any of the applied chemotherapeutic agents and/or their solvents

Trial locations and contacts

1 site in 1 country.

Netherlands1 site
  • Antoni van Leeuwenhoek/ Netherlands Cancer institute

    Amsterdam, 1066CZ

Other trials in Netherlands

About this study

Official title: Treatment of Peritoneal Dissemination in Stomach Cancer Patients With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

A randomized controlled two-armed phase III trial for gastric cancer patients with peritoneal dissemination. Randomization between gastrectomy + cytoreductive surgery + HIPEC (experimental arm) and palliative systemic chemotherapy (standard arm).

Read the detailed description

Rationale: For gastric cancer patients with peritoneal carcinomatosis palliative systemic chemotherapy is the standard treatment in the Netherlands. There are no potentially curative treatment options. Peritoneal carcinomatosis, in contrast to lymphatic and haematogenous dissemination, should be regarded as locoregional extension of disease. Administering chemotherapeutic drugs directly into the peritoneal cavity has an advantage over systemic chemotherapy since high concentrations of cytotoxic drugs can be delivered directly into the peritoneal cavity with little systemic toxicity. The combination of intraperitoneally administered chemotherapy with cytoreductive surgery and a radical gastrectomy has shown promising results in gastric cancer patients in Asia. As with other gastric cancer issues, the results obtained in Asian patients cannot be extrapolated directly to Western patients.

Objective: The primary aim of this study is to compare the overall survival between gastric cancer patients with limited peritoneal carcinomatosis and/ or tumour positive peritoneal cytology treated with gastrectomy, cytoreductive surgery and HIPEC and those treated with the current standard treatment, i.e. palliative systemic chemotherapy.

Study design : This is a multicentre randomised controlled two-armed phase III trial. Patients will be randomised (1:1) between palliative systemic chemotherapy only (standard treatment) and gastrectomy combined with cytoreductive surgery and HIPEC (experimental treatment).

Study population: Gastric cancer patients are eligible for inclusion if (1) the primary cT3-cT4 gastric tumour including regional lymph nodes is considered to be resectable, (2) limited peritoneal carcinomatosis (<7) and/ or tumour positive cytology is confirmed by laparoscopy or laparotomy, and (3) systemic chemotherapy (prior to inclusion) was without disease progression.

Main study parameters/endpoints: The study sample size (182 patients) is calculated from the hypothesis that the median overall survival of the patients treated according to protocol in the experimental arm is 18 months, as compared to a median overall survival of 10 months in the standard arm. Statistical analysis will be done according to the intention-to-treat principle.

Being tested
Cytoreductive surgery + Gastrecomy, Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Keywords
HIPEC, Hyperthermic Intraperitoneal Chemotherapy, gastrectomy, cytoreductive surgery, oxaliplatin, docetaxel
Medical subject headings
Stomach Neoplasms, Peritoneal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cytoreductive surgery + GastrecomyProcedure or surgery

    Complete cytoreduction followed by a (sub)total gastric resection with D2 lymphadenectomy.

  • Hyperthermic Intraperitoneal Chemotherapy (HIPEC)Drug

    Also called HIPEC

    HIPEC: perfusion with oxaliplatin (460mg/m2 ) (42 °C) followed by docetaxel (50mg/m2 ) (37°C)

Study groups in NCT03348150
Study groupRoleWhat they receive
Gastrecomy + Cytoreductive surgery + HIPECExperimentalGastrectomy combined with cytoreductive surgery and HIPEC (experimental treatment)
Receives: Procedure: Cytoreductive surgery + Gastrecomy; Drug: Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
palliative systemic chemotherapyNo interventionPalliative systemic chemotherapy only (standard treatment)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. overall survival

    To compare the overall survival between gastric cancer patients with limited peritoneal carcinomatosis and/ or tumour positive peritoneal cytology treated with gastrectomy, cytoreductive surgery and HIPEC and those treated with the current standard treatment, i.e. palliative systemic chemotherapy.

    Measured: 5 years

Secondary outcomes (3)
  1. progression free survival

    To compare the progression free survival between gastric cancer patients with limited peritoneal carcinomatosis and/ or tumour positive peritoneal cytology treated with gastrectomy, cytoreductive surgery and HIPEC and those treated with the current standard treatment, i.e. palliative systemic chemotherapy.

    Measured: 5 years

  2. treatment-related toxicity

    To study treatment-related toxicity in gastric cancer patients with limited peritoneal carcinomatosis and/ or tumour positive peritoneal cytology treated with gastrectomy, cytoreductive surgery and HIPEC.

    Measured: 5 years

  3. costs and health benefits

    To compare the costs and health benefits of a gastrectomy in combination with cytoreductive surgery and HIPEC, to the costs and health benefits of standard palliative systemic chemotherapy in patients with limited peritoneal carcinomatosis and/ or tumour positive peritoneal cytology.

    Measured: 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Nov 2017
  2. Study start1 Oct 2017
  3. Primary completion17 Sep 2025 (estimated)
  4. Study completion1 Oct 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
1:1 randomization
Masking
None (open label)
Enrolment
102 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03348150
Sponsor's protocol ID
M15PEC
Other IDs
2015-005695-15, NL56123.031.15, 2015
Acronym
PERISCOPEII
Status last verified
Jul 2025
First submitted
15 Nov 2017
Last updated
17 Jul 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • van der Kaaij RT, Braam HJ, Boot H, Los M, Cats A, Grootscholten C, Schellens JH, Aalbers AG, Huitema AD, Knibbe CA, Boerma D, Wiezer MJ, van Ramshorst B, van Sandick JW. Treatment of Peritoneal Dissemination in Stomach Cancer Patients With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Rationale and Design of the PERISCOPE Study. JMIR Res Protoc. 2017 Jul 13;6(7):e136. doi: 10.2196/resprot.7790.

    PubMed 28705789
  • Quik JSE, Vollebergh MA, Retel VP, van der Sluis K, Koemans WJ, van der Kaaij RT, Voets MM, Luyer MDP, van Hellemond IEG, Wijnhoven BPL, Mostert B, van Hillegersberg R, Mohammad NH, van Etten B, de Groot DJ, Helminen O, Hedberg J, Cashin PH, Harbjerg JL, Veenhof AAFA, Hartemink KJ, Kodach LL, van der Noort V, van Sandick JW; PERISCOPE II consortium. Systemic therapy, gastrectomy, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy versus systemic therapy alone for gastric cancer with limited peritoneal metastases (PERISCOPE II): final results of a multicentre, randomised, controlled, phase 3 trial after an unplanned commissioned interim analysis. Lancet Oncol. 2026 Aug;27(8):1031-1042. doi: 10.1016/S1470-2045(26)00144-0. Epub 2026 Jul 8.

    PubMed 42419336
  • Rijken A, Pape M, Simkens GA, de Hingh IHJT, Luyer MDP, van Sandick JW, van Laarhoven HWM, Verhoeven RHA, van Erning FN. Peritoneal metastases from gastric cancer in a nationwide cohort: Incidence, treatment and survival. Int J Cancer. 2024 Mar 15;154(6):992-1002. doi: 10.1002/ijc.34780. Epub 2023 Nov 2.

    PubMed 37916797
  • Koemans WJ, van der Kaaij RT, Boot H, Buffart T, Veenhof AAFA, Hartemink KJ, Grootscholten C, Snaebjornsson P, Retel VP, van Tinteren H, Vanhoutvin S, van der Noort V, Houwink A, Hahn C, Huitema ADR, Lahaye M, Los M, van den Barselaar P, Imhof O, Aalbers A, van Dam GM, van Etten B, Wijnhoven BPL, Luyer MDP, Boerma D, van Sandick JW. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy versus palliative systemic chemotherapy in stomach cancer patients with peritoneal dissemination, the study protocol of a multicentre randomised controlled trial (PERISCOPE II). BMC Cancer. 2019 May 6;19(1):420. doi: 10.1186/s12885-019-5640-2.

    PubMed 31060544

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Cytoreductive surgery + Gastrecomy and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in people with Stomach Neoplasm and Peritoneal Carcinomatosis, run by The Netherlands Cancer Institute at 1 site in Netherlands.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 17 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

overall survival (time frame: 5 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03348150, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jul 2025.

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