A recent phase l trial evaluated the safety and efficacy of combining pressurised intraperitoneal aerosol chemotherapy-oxaliplatin (PIPAC-OX) with nivolumab in patients with gastric cancer peritoneal metastases (GCPM). Eighteen patients from Singapore and Belgium participated in this international multicentre clinical trial, receiving PIPAC-OX every 6 weeks and nivolumab biweekly. The combination therapy was well tolerated, with most side effects being manageable. Significant reductions in peritoneal cancer index and enhanced immune infiltration were observed, highlighting increased T-cell presence and reduced M2 macrophages in tumour samples. This trial establishes a foundation for future strategies combining systemic immunotherapy with localised intraperitoneal treatments.

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