Intraperitoneal Immune Checkpoint Inhibitor for Malignant Ascites

This projectis aim to evaluate the efficacy of immune checkpoint inhibitor (pembrolizumab or nivolumab) on the malignant ascites of patients with advanced gastric, pancreatic and biliary tract cancers.

Inclusion Criteria:Patients have cyto-/histologically confirmed malignant ascites from gastric, pancreatic or biliary tract adenocarcinomaPatients have malignant ascites more than 1000mlPatients have no history of prior intraperitoneal therapy for malignant ascitesPatients have life expectancy of at least 4 weeksPatients have adequate platelet count ≥ 50,000/ulWomen or men of reproductive potential should agree to use an effective contraceptive methodAll patients must be informed of the investigational nature of this study and must sign written informed consents.Exclusion Criteria:Patients have ascites which is related to causes other than the malignanciesPatients who are receiving intraperitoneal treatment for their malignant ascites including therapeutic paracentesisPatients with active infectionPatients with bleeding disordersPatient with active cardiopulmonary disease or history of ischemic heart diseasePatients have intolerant abdominal painPatients who have serious concomitant systemic disorders incompatible with the study, i.e. poorly controlled diabetes mellitus, auto-immune disorders, cirrhosis of the liver, and the rest will be at the discretion of in-charged investigator