Pressurised intraperitoneal aerosol chemotherapy: rationale, evidence, and potential indications.

Details

Serval ID
serval:BIB_8AFF34473ED9
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Pressurised intraperitoneal aerosol chemotherapy: rationale, evidence, and potential indications.
Journal
The Lancet. Oncology
Author(s)
Alyami M., Hübner M., Grass F., Bakrin N., Villeneuve L., Laplace N., Passot G., Glehen O., Kepenekian V.
ISSN
1474-5488 (Electronic)
ISSN-L
1470-2045
Publication state
Published
Issued date
07/2019
Peer-reviewed
Oui
Volume
20
Number
7
Pages
e368-e377
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Pressurised intraperitoneal aerosol chemotherapy (PIPAC) was introduced as a new treatment for patients with peritoneal metastases in November, 2011. Reports of its feasibility, tolerance, and efficacy have encouraged centres worldwide to adopt PIPAC as a novel drug delivery technique. In this Review, we detail the technique and rationale of PIPAC and critically assess its evidence and potential indications. A systematic search was done to identify all relevant literature on PIPAC published between Jan 1, 2011, and Jan 31, 2019. A total of 106 articles or reports on PIPAC were identified, and 45 clinical studies on 1810 PIPAC procedures in 838 patients were included for analysis. Repeated PIPAC delivery was feasible in 64% of patients with few intraoperative and postoperative surgical complications (3% for each in prospective studies). Adverse events (Common Terminology Criteria for Adverse Events greater than grade 2) occurred after 12-15% of procedures, and commonly included bowel obstruction, bleeding, and abdominal pain. Repeated PIPAC did not have a negative effect on quality of life. Using PIPAC, an objective clinical response of 62-88% was reported for patients with ovarian cancer (median survival of 11-14 months), 50-91% for gastric cancer (median survival of 8-15 months), 71-86% for colorectal cancer (median survival of 16 months), and 67-75% (median survival of 27 months) for peritoneal mesothelioma. From our findings, PIPAC has been shown to be feasible and safe. Data on objective response and quality of life were encouraging. Therefore, PIPAC can be considered as a treatment option for refractory, isolated peritoneal metastasis of various origins. However, its use in further indications needs to be validated by prospective studies.
Keywords
Aerosols, Antineoplastic Agents/administration & dosage, Drug Delivery Systems/methods, Humans, Peritoneal Neoplasms/drug therapy, Peritoneal Neoplasms/secondary, Pressure
Pubmed
Web of science
Create date
18/07/2019 17:11
Last modification date
07/07/2020 6:20
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