A Phase II Study of Ivonescimab Combined With Intraperitoneal Paclitaxel in Patients With High-Grade Metastatic Appendiceal Adenocarcinoma (AA)

Inclusion Criteria * Age 18 years and above. There will be no upper age restriction * ECOG performance status 0-2 * Participants must have histologically confirmed diagnosis of unresectable metastatic AA. The determination of appendiceal origin may rely on pathologic features combined with clinical or radiographic evidence in the event that the appendix remains in situ. * Participants will have undergone no more than two prior lines of systemic therapy. The last dose of systemic therapy will have been no less than 2 weeks prior to initiation of therapy. * Participants must have adequate nutrition and normal bowel motility and function as evidenced by albumin \> 3.0 and no history of intestinal bypass or diverting enterostomy. * Demonstrate adequate organ function as determined by the following requirements: o Hematology * No use of any blood components and cell growth factor supportive therapy within 7 days prior to initiation of study treatment * Absolute neutrophil count (ANC) ≥ 1,500/mm3 (ANC ≥ 1000/mm3 for African American participants) * Platelet count ≥ 100 × 109/L (100,000/mm3) * Hemoglobin ≥ 9.0 g/dL. o Kidney: * Creatinine clearance\* (CrCL) ≥ 50 mL/min using the Cockcroft-Gault formula or estimated glomerular filtration rate (eGFR) value ≥50 mL/min using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation (adjustment by body surface area \[BSA\] is not required for eGFR). \*CrCL or eGFR can be determined using the calculator from the Nati…