Catheter based intraperitoneal chemotherapy using taxane for peritoneal metastases from gastric cancer: from bench to bedside—a narrative review

Peritoneal metastasis (PM) is the most common and clinically devastating mode of spread in Gastric Cancer. Despite advances in systemic therapy, outcomes for gastric cancer with peritoneal metastasis (GCPM) remain poor, largely because the distinctive biology of PM, including sparse vascularization and the peritoneal-plasma barrier, restricts drug delivery and promotes therapeutic resistance. To overcome these limitations, locoregional approaches such as cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) have been introduced, but their broader use remains limited by invasiveness, patient selection challenges, and variable survival benefits. In this setting, catheter-based normothermic intraperitoneal chemotherapy (CBIP) has emerged as a practical and scalable strategy, particularly in East Asia. By enabling repeated intraperitoneal administration through an implanted port, CBIP provides sustained regional drug exposure with minimal procedural burden and can be readily combined with systemic therapy. Among available agents, Paclitaxel and Docetaxel are especially suitable because of their prolonged peritoneal retention and low systemic absorption. Accordingly, taxane-based CBIP represents a biologically rational and clinically feasible platform for GCPM. In this review, we summarize its pharmacologic basis, clinical evidence, and future innovations in drug formulation and delivery that may further improve outcomes in this highly challenging disease.