Conversion Surgery for Gastric Cancer With Peritoneal Metastases (CONVERGENCE)

The goal of this clinical trial is to evaluate the impact of conversion surgery on overall survival (OS) in patients with gastric cancer peritoneal metastases (GCPM) who show a good response to preoperative systemic therapy (including first-line chemotherapy with or without targeted therapy and/or immunotherapy) with or without peritoneal-directed chemotherapy.\]. The main question it aims to answer is: (i) Will Conversion surgery be associated with improved overall survival (OS) in patients with GCPM who respond well to preoperative systemic therapy, compared to patients who do not undergo surgery? (ii) Will Quality of life be comparable or improved in patients who undergo conversion surgery compared to patients receiving palliative chemotherapy as measured by the QLQ-C30 questionnaire? If there is a comparison group: Researchers will compare Arm 1 (Conversion surgery with systemic therapy (including 1L chemotherapy +/- targeted therapy +/- immunotherapy) +/- peritoneal directed chemotherapy) to Arm 2 (systemic therapy alone (including 1L chemotherapy +/- targeted therapy +/- immunotherapy) +/- peritoneal directed chemotherapy) to see if the conversion surgery will be associated with improved overall survival (OS) in Arm 1. Participants will be randomized to either Arm 1 or Arm 2. * For Arm 1, participants will go for conversion surgery then continue systemic therapy. * For Arm 2, participants will continue systemic therapy. Radiological assessment will be performed every 6 months or upon progression of disease, whichever comes earlier.

NCT Number	NCT07241715
Lead Sponsor	National University Hospital, Singapore Collaborators: Karolinska University Hospital, University of Lyon, M.D. Anderson Cancer Center, Seoul National University Hospital, University of Oxford, Peter MacCallum Cancer Centre, Australia, Queen Mary Hospital, Hong Kong, Chinese University of Hong Kong, University Hospital, Lille, Erasmus Medical Center, University Hospital, Montpellier, Universita di Verona, Antoni van Leeuwenhoek Hospital
Conditions	Gastric Cancer Stage IV, Peritoneal Metastasis
Enrollment	300 participants
Start Date	2026-02-21
Primary Completion	2034-01 (estimated)
Study Completion	2034-01 (estimated)
Updated on ClinicalTrials.gov	2026-05-14