HIPEC Methodology and Regimens: The Need for an Expert Consensus.

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State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_8D11C1264382
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
HIPEC Methodology and Regimens: The Need for an Expert Consensus.
Journal
Annals of surgical oncology
Author(s)
Bhatt A., de Hingh I., Van Der Speeten K., Hubner M., Deraco M., Bakrin N., Villeneuve L., Kusamura S., Glehen O.
ISSN
1534-4681 (Electronic)
ISSN-L
1068-9265
Publication state
Published
Issued date
12/2021
Peer-reviewed
Oui
Volume
28
Number
13
Pages
9098-9113
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Hyperthermic intraperitoneal chemotherapy (HIPEC) is performed with a wide variation in methodology, drugs, and other elements vital to the procedure. Adoption of a limited number of regimens could increase the collective experience of peritoneal oncologists, make comparison between studies more meaningful, and lead to a greater acceptance of results from randomized trials. This study aimed to determine the possibility of standardizing HIPEC methodology and regimens and to identify the best method of performing such a standardization.
A critical review of preclinical and clinical studies evaluating the pharmacokinetic aspects of different HIPEC drugs and drug regimens, the impact of hyperthermia, and the efficacy of various HIPEC regimens as well as studies comparing different regimens was performed.
The preclinical and clinical data were limited, and studies comparing different regimens were scarce. Many of the regimens were neither supported by preclinical rationale or data nor validated by a dose-escalating formal phase 1 trial. All the regimens were based on pharmacokinetic data and did not take chemosensitivity of peritoneal metastases into account. Personalized medicine approaches such as patient-derived tumor organoids could offer a solution to this problem, although clinical validation is likely to be challenging.
Apart from randomized trials, more translational research and phases 1 and 2 studies are needed. While waiting for better preclinical and clinical evidence, the best way to minimize heterogeneity is by an expert consensus that aims to identify and define a limited number of regimens for each indication and primary site. The choice of regimen then can be tailored to the patient profile and its expected toxicity and the methodology according regional factors.
Keywords
Combined Modality Therapy, Consensus, Cytoreduction Surgical Procedures, Humans, Hyperthermia, Induced, Hyperthermic Intraperitoneal Chemotherapy, Peritoneal Neoplasms/drug therapy
Pubmed
Web of science
Open Access
Yes
Create date
29/06/2021 11:26
Last modification date
25/01/2022 8:10
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