Intraperitoneal aerosolized drug delivery: Technology, recent developments, and future outlook

Area of Science:

• Oncology
• Surgical Oncology
• Drug Delivery Systems

Background:

• Current therapies for peritoneal metastases (PM) demonstrate limited efficacy.
• Peritoneal metastases significantly impact patient prognosis and quality of life.

Purpose of the Study:

• To review the rationale, indications, technology, and early clinical results of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC).
• To discuss the mechanisms of aerosol deposition and novel approaches in PIPAC for PM treatment.

Main Methods:

• Review of existing literature on PIPAC for peritoneal metastases.
• Discussion of aerosol particle transport, peritoneal deposition, and electrostatic aerosol precipitation.
• Exploration of emerging PIPAC technologies, including nanoparticles and prolonged release formulations.

Main Results:

• PIPAC utilizes laparoscopy with intraperitoneal aerosolized chemotherapy delivery under elevated pressure.
• Repeated PIPAC cycles aid in accurate disease staging and histological response assessment.
• Early clinical results in patients with advanced PM are promising.

Conclusions:

• PIPAC represents a novel locoregional treatment with potential to enhance drug penetration and treatment monitoring for PM.
• Further research into advanced PIPAC formulations, such as nanoparticles, holds promise for improved therapeutic outcomes.