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Erschienen in: Wiener Medizinische Wochenschrift 23-24/2014

01.12.2014 | review

Pressurized intraperitoneal chemotherapy (PIPAC) in women with gynecologic malignancies: a review

verfasst von: Prof. Clemens B. Tempfer, MD, MBA, Wiebke Solass, MD, Prof. Marc-André Reymond, MD

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 23-24/2014

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Summary

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.
Literatur
1.
Zurück zum Zitat Foley OW, Rauh-Hain JA, del Carmen MG. Recurrent epithelial ovarian cancer: an update on treatment. Oncology. 2013;27(4):288–94.PubMed Foley OW, Rauh-Hain JA, del Carmen MG. Recurrent epithelial ovarian cancer: an update on treatment. Oncology. 2013;27(4):288–94.PubMed
2.
Zurück zum Zitat Hanker LC, Loibl S, Burchardi N, Pfisterer J, Meier W, Pujade-Lauraine E, Ray-Coquard I, Sehouli J, Harter P, du Bois A, AGO and GINECO study group. The impact of second to sixth line therapy on survival of relapsed ovarian cancer after primary taxane/platinum-based therapy. Ann Oncol. 2012;23(10):2605–12.PubMedCrossRef Hanker LC, Loibl S, Burchardi N, Pfisterer J, Meier W, Pujade-Lauraine E, Ray-Coquard I, Sehouli J, Harter P, du Bois A, AGO and GINECO study group. The impact of second to sixth line therapy on survival of relapsed ovarian cancer after primary taxane/platinum-based therapy. Ann Oncol. 2012;23(10):2605–12.PubMedCrossRef
3.
Zurück zum Zitat Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Copeland LJ, Walker JL, Burger RA, Gynecologic Oncology Group. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006;354(1):34–43.PubMedCrossRef Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Copeland LJ, Walker JL, Burger RA, Gynecologic Oncology Group. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006;354(1):34–43.PubMedCrossRef
4.
Zurück zum Zitat Gadducci A, Conte PF. Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature. Int J Gynecol Cancer. 2008;18(5):943–53.PubMedCrossRef Gadducci A, Conte PF. Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature. Int J Gynecol Cancer. 2008;18(5):943–53.PubMedCrossRef
5.
Zurück zum Zitat Varona JF, Guerra JM, Salamanca J, Colina F, Lopez G, Morales M. Pseudomyxoma peritonei: a clinicopathologic analysis and follow-up of 21 patients. Hepatogastroenterology. 2005;52(63):812–6.PubMed Varona JF, Guerra JM, Salamanca J, Colina F, Lopez G, Morales M. Pseudomyxoma peritonei: a clinicopathologic analysis and follow-up of 21 patients. Hepatogastroenterology. 2005;52(63):812–6.PubMed
6.
Zurück zum Zitat McBride K, McFadden D, Osler T. Improved survival of patients with pseudomyxoma peritonei receiving intraperitoneal chemotherapy with cytoreductive surgery: a systematic review and meta-analysis. J Surg Res. 2013;183(1):246–52.PubMedCrossRef McBride K, McFadden D, Osler T. Improved survival of patients with pseudomyxoma peritonei receiving intraperitoneal chemotherapy with cytoreductive surgery: a systematic review and meta-analysis. J Surg Res. 2013;183(1):246–52.PubMedCrossRef
7.
Zurück zum Zitat Saxena A, Yan TD, Chua TC, Morris DL. Critical assessment of risk factors for complications after cytoreductive surgery and perioperative intraperitoneal chemotherapy for pseudomyxoma peritonei. Ann Surg Oncol. 2010;17(5):1291–301.PubMedCrossRef Saxena A, Yan TD, Chua TC, Morris DL. Critical assessment of risk factors for complications after cytoreductive surgery and perioperative intraperitoneal chemotherapy for pseudomyxoma peritonei. Ann Surg Oncol. 2010;17(5):1291–301.PubMedCrossRef
8.
Zurück zum Zitat Eskander RN, Tewari KS. Emerging treatment options for management of malignant ascites in patients with ovarian cancer. Int J Womens Health. 2012;4:395–404.PubMedCentralPubMed Eskander RN, Tewari KS. Emerging treatment options for management of malignant ascites in patients with ovarian cancer. Int J Womens Health. 2012;4:395–404.PubMedCentralPubMed
9.
Zurück zum Zitat Dedrick RL, Flessner MF. Pharmacokinetic problems in peritoneal drug administration: tissue penetration and surface exposure. J Natl Cancer Inst. 1997;89:480–7.PubMedCrossRef Dedrick RL, Flessner MF. Pharmacokinetic problems in peritoneal drug administration: tissue penetration and surface exposure. J Natl Cancer Inst. 1997;89:480–7.PubMedCrossRef
10.
Zurück zum Zitat Esquis P, Consolo D, Magnin G, Pointaire P, Moretto P, Ynsa MD, Beltramo JL, Drogoul C, Simonet M, Benoit L, Rat P, Chauffert B. High intra-abdominal pressure enhances the penetration and antitumor effect of intraperitoneal cisplatin on experimental peritoneal carcinomatosis. Ann Surg. 2006;244(1):106–12.PubMedCentralPubMedCrossRef Esquis P, Consolo D, Magnin G, Pointaire P, Moretto P, Ynsa MD, Beltramo JL, Drogoul C, Simonet M, Benoit L, Rat P, Chauffert B. High intra-abdominal pressure enhances the penetration and antitumor effect of intraperitoneal cisplatin on experimental peritoneal carcinomatosis. Ann Surg. 2006;244(1):106–12.PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Solass W, Herbette A, Schwarz T, Hetzel A, Sun JS, Dutreix M, Reymond MA. Therapeutic approach of human peritoneal carcinomatosis with Dbait in combination with capnoperitoneum: proof of concept. Surg Endosc. 2012;26(3):847–52.PubMedCentralPubMedCrossRef Solass W, Herbette A, Schwarz T, Hetzel A, Sun JS, Dutreix M, Reymond MA. Therapeutic approach of human peritoneal carcinomatosis with Dbait in combination with capnoperitoneum: proof of concept. Surg Endosc. 2012;26(3):847–52.PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Solass W, Hetzel A, Nadiradze G, Sagynaliev E, Reymond MA. Intraoperative intraperitonal drug delivery using a nebulizer: rationale and pharmacokinetic results. Surg Endosc. 2012;26(7):1849–55.PubMedCrossRef Solass W, Hetzel A, Nadiradze G, Sagynaliev E, Reymond MA. Intraoperative intraperitonal drug delivery using a nebulizer: rationale and pharmacokinetic results. Surg Endosc. 2012;26(7):1849–55.PubMedCrossRef
13.
Zurück zum Zitat Solass W, Kerb R, Muerdter T, Giger U, Strumberg D, Tempfer C, Zieren J, Schwab M. Reymond. intraperitoneal chemotherapy of peritoneal carcinomatosis using pressurized aerosol as an alternative to liquid solution: first evidence for efficacy. Ann Surg Oncol. 2014;21(2):553–9.PubMedCentralPubMedCrossRef Solass W, Kerb R, Muerdter T, Giger U, Strumberg D, Tempfer C, Zieren J, Schwab M. Reymond. intraperitoneal chemotherapy of peritoneal carcinomatosis using pressurized aerosol as an alternative to liquid solution: first evidence for efficacy. Ann Surg Oncol. 2014;21(2):553–9.PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Solass W, Giger-Pabst U, Zieren J, Reymond MA. Pressurized intraperitoneal aerosol chemotherapy (PIPAC): occupational health and safety aspects. Ann Surg Oncol. 2013;20(11):3504–11.PubMedCentralPubMedCrossRef Solass W, Giger-Pabst U, Zieren J, Reymond MA. Pressurized intraperitoneal aerosol chemotherapy (PIPAC): occupational health and safety aspects. Ann Surg Oncol. 2013;20(11):3504–11.PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Blanco A, Giger-Pabst U, Solass W, Zieren J, Reymond MA. Renal and hepatic toxicities after pressurized intraperitoneal aerosol chemotherapy (PIPAC). Ann Surg Oncol. 2013;20(7):2311–6.PubMedCentralPubMedCrossRef Blanco A, Giger-Pabst U, Solass W, Zieren J, Reymond MA. Renal and hepatic toxicities after pressurized intraperitoneal aerosol chemotherapy (PIPAC). Ann Surg Oncol. 2013;20(7):2311–6.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Tempfer CB, Celik I, Solass W, Buerkle B, Pabst UG, Zieren J, Strumberg D, Reymond MA. Activity of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) with cisplatin and doxorubicin in women with recurrent, platinum-resistant ovarian cancer: preliminary clinical experience. Gynecol Oncol. 2014;132(2):307–11.PubMedCrossRef Tempfer CB, Celik I, Solass W, Buerkle B, Pabst UG, Zieren J, Strumberg D, Reymond MA. Activity of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) with cisplatin and doxorubicin in women with recurrent, platinum-resistant ovarian cancer: preliminary clinical experience. Gynecol Oncol. 2014;132(2):307–11.PubMedCrossRef
17.
Zurück zum Zitat Tempfer C, Solass W, Buerkle B, Reymond MA. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in a woman with pseudomyxoma peritonei. Int J Gynecol Cancer, submitted (2014). Tempfer C, Solass W, Buerkle B, Reymond MA. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in a woman with pseudomyxoma peritonei. Int J Gynecol Cancer, submitted (2014).
18.
Zurück zum Zitat Giger-Pabst U, Solass W, Buerkle B, Reymond MA, Tempfer C. Low-dose pressurized intraperitoneal aerosol chemotherapy (PIPAC) as an alternative therapy for ovarian cancer in an octogenarian patient. Gynecol Oncol Case Reports, submitted (2014). Giger-Pabst U, Solass W, Buerkle B, Reymond MA, Tempfer C. Low-dose pressurized intraperitoneal aerosol chemotherapy (PIPAC) as an alternative therapy for ovarian cancer in an octogenarian patient. Gynecol Oncol Case Reports, submitted (2014).
21.
Zurück zum Zitat Mazzei MA, Khader L, Cirigliano A, Cioffi Squitieri N, Guerrini S, Forzoni B, Marrelli D, Roviello F, Mazzei FG, Volterrani L. Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Abdom Imaging. 2013;38(6):1422–30.PubMedCrossRef Mazzei MA, Khader L, Cirigliano A, Cioffi Squitieri N, Guerrini S, Forzoni B, Marrelli D, Roviello F, Mazzei FG, Volterrani L. Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Abdom Imaging. 2013;38(6):1422–30.PubMedCrossRef
22.
Zurück zum Zitat Common Terminology Criteria for Adverse Events (CTCAE) version 4.0; published: May 28, 2009 (v4.03: June 14, 2010); U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) version 4.0; published: May 28, 2009 (v4.03: June 14, 2010); U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute.
23.
Zurück zum Zitat Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.PubMedCrossRef Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.PubMedCrossRef
Metadaten
Titel
Pressurized intraperitoneal chemotherapy (PIPAC) in women with gynecologic malignancies: a review
verfasst von
Prof. Clemens B. Tempfer, MD, MBA
Wiebke Solass, MD
Prof. Marc-André Reymond, MD
Publikationsdatum
01.12.2014
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 23-24/2014
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-014-0312-y

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