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This combination treatment regimen is being investigated in the Phase II STOPGAP clinical trial at the University of California, Irvine, for the treatment of gastric cancer and gastroesophageal junction (GEJ) adenocarcinoma with peritoneal carcinomatosis. The protocol utilizes a bidirectional approach, combining intraperitoneal (IP) and intravenous (IV) administration of paclitaxel with IV fluorouracil and leucovorin. Paclitaxel functions as a microtubule-stabilizing agent that disrupts mitosis, while fluorouracil is an antimetabolite that inhibits thymidylate synthase to prevent DNA synthesis. Leucovorin is included as a biochemical modulator to enhance the binding of fluorouracil to its target. This strategy, known as normothermic intraperitoneal chemotherapy (NIPEC), is designed to overcome the blood-peritoneal barrier and deliver high concentrations of chemotherapy directly to the peritoneal cavity.
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