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

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Accès restreint UNIL
Etat: Public
Version: Final published version
Licence: Non spécifiée
ID Serval
serval:BIB_8D11C1264382
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
HIPEC Methodology and Regimens: The Need for an Expert Consensus.
Périodique
Annals of surgical oncology
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
12/2021
Peer-reviewed
Oui
Volume
28
Numéro
13
Pages
9098-9113
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
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.
Mots-clé
Combined Modality Therapy, Consensus, Cytoreduction Surgical Procedures, Humans, Hyperthermia, Induced, Hyperthermic Intraperitoneal Chemotherapy, Peritoneal Neoplasms/drug therapy
Pubmed
Web of science
Création de la notice
29/06/2021 11:26
Dernière modification de la notice
08/06/2023 6:54
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