PIPAC Nab-pac for Stomach, Pancreas, Breast and Ovarian Cancer

Inclusion Criteria: * Phase I study: patients with advanced carcinomatosis from ovarian, breast, gastric, or pancreatic origin. No alternative systemic treatment options are available. * Age over 18 years * Adequate performance status (Karnofsky index \> 60%) * Absence of intestinal or urinary obstruction * Limited size of the majority of peritoneal tumor implants (\< 5 mm) * Absent or limited ascites * Ability to understand the proposed treatment protocol and provide informed consent * Expected life expectancy more than 6 months * Laboratory data * Serum creatinine ≤ 1.5 mg/dl or a calculated GFR (CKD-EPI) ≥ 60 mL/min/1.73 m² * Serum total bilirubin ≤ 1.5 mg/dl, except for known Gilbert's disease * Platelet count \> 100.000/µl * Hemoglobin \> 9g/dl * Neutrophil granulocytes \> 1.500/ml * No major blood coagulation disorders. Parameters within normal range. * Absence of alcohol and/or drug abuse * No other concurrent malignant disease * Written informed consent Exclusion Criteria: * Pregnancy or breast feeding. Women who can become pregnant must ensure effective contraception. * Active bacterial, viral or fungal infection * Active gastro-duodenal ulcer * Parenchymal liver disease (any stage cirrhosis) * Uncontrolled diabetes mellitus * Psychiatric pathology affecting comprehension and judgement faculty * General or local (abdominal) contra-indications for laparoscopic surgery * Documented intolerance or allergy to paclitaxel * Patients who receive other taxane…