Long-term survival in peritoneal mesothelioma treated with 24 consecutive PIPACs

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Malignant peritoneal mesothelioma (MPM) is a rare cancer often diagnosed at advanced stages.
• Current treatments include radical surgery for cure or systemic chemotherapy for palliation.
• Pressurized intraperitoneal aerosol chemotherapy (PIPAC) delivers high-dose chemotherapy intraperitoneally for palliative care.

Purpose of the Study:

• To report a case of unresectable malignant peritoneal mesothelioma treated with an individualized PIPAC approach.
• To evaluate the efficacy and safety of PIPAC in a long-term palliative setting.

Main Methods:

• A male patient with unresectable MPM received PIPAC with doxorubicin and cisplatin.
• Treatment was initiated in 2017, with therapy cycles adjusted based on disease progression.
• The patient underwent a total of 24 PIPAC procedures over seven years.

Main Results:

• The patient achieved stable disease within one year of PIPAC treatment, allowing a 2.5-year therapy break.
• Following disease progression, continued PIPAC resulted in an additional two years of stable disease.
• Over seven years, 24 PIPAC procedures were administered with no major surgical or toxic side effects.

Conclusions:

• PIPAC can achieve long-term disease control in patients with unresectable malignant peritoneal mesothelioma.
• This case highlights the potential of PIPAC as an effective and safe palliative treatment option for MPM.
• Individualized PIPAC therapy contributed to seven years of long-term survival in this patient.