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Pressurized intraperitoneal chemotherapy (PIPAC) in women with gynecologic malignancies: a review
Clemens B Tempfer1, Wiebke Solass, Marc-André Reymond
1Department of Obstetrics and Gynecology, Ruhr University Bochum, Hoelkeskampring 40, 44625, Herne, Germany, clemens.tempfer@marienhospital-herne.de.
Objective:
The objective of this study was to provide an overview of published and ongoing trials of pressurized intraperitoneal chemotherapy (PIPAC) in ovarian cancer.
Design:
The study comprised a systematic literature review.
Results:
We identified 10 studies, including 2 ex vivo and in vitro studies, 6 clinical studies, and 2 ongoing clinical trials using PIPAC in women with recurrent ovarian cancer and pseudomyxoma peritonei. Experimental evidence and clinical study data demonstrate that PIPAC increases peritoneal cavity coverage and depth of peritoneal infiltration, and is technically feasible. Occupational safety has been established. PIPAC has demonstrated antitumor activity based on histological, radiological, and clinical evidence. The toxicity of PIPAC is manageable and restricted to Common Terminology Criteria for Adverse Events grade 2-3 events when used without concomitant cytoreductive surgery. Further clinical trials assessing efficacy and dose escalation are ongoing.
Conclusions:
PIPAC is technically feasible, has a safe local and systemic safety profile, and has antitumor activity in women with peritoneal carcinomatosis from recurrent ovarian cancer.
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