Actively Recruiting

Phase 3
Age: 18Years - 79Years
All Genders
ID04861558

EFFIPEC - Efficacy of Hyperthermic Intraperitoneal Chemotherapy Comparing Standard Oxaliplatin HIPEC to Intensified Oxaliplatin/Irinotecan HIPEC with Postoperative 5-Fluorouracil in Colorectal Cancer with Peritoneal Metastases

Led by Uppsala University · Updated on 2025-05-30

213

Participants Needed

5

Research Sites

208 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating treatments for patients with colorectal cancer who have peritoneal metastases, with or without limited liver metastases. This study combines a dose titration phase and an open-label randomized control trial using registry-based follow-up to compare the effectiveness of two types of hyperthermic intraperitoneal chemotherapy (HIPEC). The study aims to understand if adding irinotecan and 5-fluorouracil (5-FU) to the standard oxaliplatin HIPEC improves outcomes. Follow-up will assess recurrence, survival, complications, and quality of life up to five years. Participants will undergo cytoreductive surgery (CRS) followed by either the standard HIPEC with oxaliplatin and intravenous 5-fluorouracil during surgery, or an intensified HIPEC combining oxaliplatin, irinotecan, and a 24-hour postoperative infusion of 5-FU through abdominal drains. The 5-FU dose will be given in two equal injections through drains clamped for 16 hours. The dose escalation part monitors small groups of patients for 30 days before adjusting doses, while the randomized phase assigns patients intraoperatively to either treatment. The long-term follow-up uses registry data to track outcomes without extra study visits. During the study, patients will be monitored for recurrence-free survival at 24 months, overall survival and recurrence at 5 years, postoperative complications within 30 days, and quality of life over 3 years. Specific evaluations, adverse event reporting, and eligibility data are collected within the HIPEC registry. The trial includes standard laboratory tests and clinical assessments to ensure safety and treatment tolerability. Participants will be followed through routine care and registry records for up to five years after treatment.

CONDITIONS

Brief Title

Efficacy of Hyperthermic Intraperitoneal Chemotherapy

Who Can Participate

Age: 18Years - 79Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Written informed consent provided before any study procedures
  • ECOG Performance Status 0, 1, or 2, or Karnofsky score 60-100
  • Adequate kidney, liver, and bone marrow function by lab tests
  • Negative pregnancy test for women of childbearing potential
  • Age between 18 and 78 years
  • Diagnosis of colorectal cancer with peritoneal metastases, with or without up to 3 liver metastases
  • Resectable pulmonary metastases allowed
  • Eligibility for cytoreductive surgery and HIPEC confirmed by multidisciplinary board
Not Eligible

You will not qualify if you...

  • Previous severe allergic reactions or toxicity to oxaliplatin, irinotecan, or 5-fluorouracil
  • Unable to tolerate intensified HIPEC due to other health conditions
  • Metastases outside peritoneum, liver, or lung
  • Complex liver surgery such as hemihepatectomy planned
  • Prior cytoreductive surgery or HIPEC treatment
  • Pregnant or breastfeeding women
  • Active infections requiring antibiotics
  • Active liver disease with hepatitis B, C, or HIV
  • Other cancer treatments within 4 weeks before or after study treatment
  • Incomplete cytoreduction with score 2 or 3
  • Cancer histology other than colorectal origin

AI-Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Surgery and Immediate Post-operative Care

Duration - Up to 1 week or until discharge

Participants undergo cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) with either standard or intensified drug regimens, including intraoperative and postoperative drug injections.

1 hospitalization period including surgery and immediate post-operative monitoring

Treatment

Duration - Approximately 4 to 5 days post-surgery

Participants receive postoperative chemotherapy with 5-fluorouracil administered through abdominal drains as part of the intensified treatment arm.

Daily administration during hospital stay

Follow-up

Duration - Up to 5 years after treatment

Participants are monitored for recurrence-free and overall survival, postoperative complications, and quality of life over several years after treatment.

Regular follow-up visits over 5 years

Trial Site Locations

Total: 5 locations

1

INDEPSO

Ahmedabad, India

Actively Recruiting

2

Sahlgrenska östra sjukhuset

Gothenburg, Sweden

Actively Recruiting

3

Skånes universitetssjukhus

Malmö, Sweden

Actively Recruiting

4

Karolinska sjukhuset

Stockholm, Sweden

Actively Recruiting

5

Akademiska sjukhuset

Uppsala, Sweden, 75185

Actively Recruiting

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Research Team

P

Peter Cashin, MD, PhD

L

Lana Ghanipour, MD, PhD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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