Melphalan and cytarabine administered intraperitoneally as single agents and combination intraperitoneal chemotherapy...

At the UCSD Cancer Center several chemotherapeutic agents have been evaluated for safety and clinical utility when delivered by the intraperitoneal route. Both melphalan and cytarabine have demonstrated a major pharmacokinetic advantage for peritoneal cavity exposure to drug compared to that of the plasma when these agents are administered directly into the abdominal cavity. In addition, limited clinical efficacy for both agents has been demonstrated. In one experimental system cisplatin and cytarabine have shown significant concentration-dependent synergy. As intraperitoneal drug delivery allows one to administer extremely high concentrations of chemotherapeutic agents to tumors localized to the abdominal cavity, this therapeutic approach is perhaps the optimal method for producing clinically relevant concentration-dependent drug synergy. Patients with refractory ovarian carcinoma and other tumors principally confined to the peritoneal cavity have demonstrated subjective and objective improvement following intraperitoneal therapy with a cisplatin-cytarabine-based chemotherapeutic regimen.