Intraperitoneal chemotherapy in the management of malignant disease

The intraperitoneal administration of antineoplastic agents has been proposed as a method to improve the efficacy of therapy of malignant disease principally confined to the peritoneal cavity. Phase I studies have demonstrated the safety and pharmacokinetic advantage for a number of drugs delivered directly into the body compartment, with surgically-defined responses documented in the Phase II trial setting. More recently reported randomized Phase III studies have revealed a survival benefit associated with the use of intraperitoneal cisplatin, compared to i.v. drug delivery when employed as initial treatment of small volume residual advanced ovarian cancer. While there is far less experience with regional therapy of gastrointestinal cancers, limited data suggest intraperitoneal drug administration should be further explored as a potentially important strategy to improve the outcome for this group of malignancies.