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Intraperitoneal Chemotherapy for Unresectable Peritoneal Surface Malignancies.
Niels A D Guchelaar1, Bo J Noordman2, Stijn L W Koolen3,4
1Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. n.guchelaar@erasmusmc.nl.
Drugs
|January 12, 2023
Summary
Intraperitoneal chemotherapy offers a promising approach for unresectable peritoneal malignancies, overcoming systemic delivery limitations. Further research is needed to optimize treatment schedules and confirm its role alongside standard therapies.
Area of Science:
- Oncology
- Surgical Oncology
- Pharmacology
Background:
- Malignancies of the peritoneal cavity have a poor prognosis.
- Systemic chemotherapy's efficacy is limited by the peritoneal-plasma barrier.
- Intraperitoneal chemotherapy presents a novel treatment strategy.
Purpose of the Study:
- To systematically review drugs used in intraperitoneal chemotherapy.
- To summarize clinical studies and complications of intraperitoneal chemotherapy.
- To evaluate the potential of intraperitoneal chemotherapy for unresectable peritoneal disease.
Main Methods:
- Systematic review of existing literature.
- Analysis of clinical studies (Phase I, II, and III).
- Evaluation of drug efficacy and safety profiles.
Main Results:
- Taxanes (paclitaxel, docetaxel) are commonly used.
- Phase I/II studies show promising results for various cancers (gastric, ovarian, colorectal, pancreatic).
- Phase III studies in gastric cancer show contradictory results; Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) shows a tolerable safety profile.
Conclusions:
- Intraperitoneal chemotherapy, particularly with taxanes, shows potential for unresectable peritoneal disease.
- More Phase II/III studies are required to establish optimal treatment and confirm its role.
- Further research should focus on tolerability, survival rates, and quality of life.
