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Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) Proves Effective Against End-Stage Mesothelioma

Researchers at Basic Research Laboratories at Marien Hospital Herne say a procedure known as Pressurized IntraPeritoneal/Thoracal Aerosol Chemotherapy (PIPAC/PITAC) has a positive effect on patients with end-stage malignant mesothelioma (MM).

BMC Cancer, part of Springer Nature, says PIPAC is a “new technique to deliver intraperitoneal chemotherapy” or IPC. “During a standard laparoscopy,” BMC explains, “antitumor drugs are injected via a nebulizer into the abdominal cavity where a therapeutic aerosol is formed.” Data from animal experiments, and human and ex-vivo studies, “demonstrated a higher local drug bioavailability and a better therapeutic index after PIPAC compared to liquid IPC.”

“Clinical safety, feasibility, and anti-tumor efficacy of PIPAC have been reported in ovarian and gastrointestinal cancer patients with peritoneal carcinomatosis.” The feasibility of PITAC to palliate malignant pleural effusion has been reported previously.

For the PIPAC study, researchers performed a retrospective cohort analysis of patients with recurrent MM undergoing PIPAC/PITAC with the chemotherapy drugs doxorubicin and cisplatin.

Twenty-nine patients with MM with a mean age of 62.4 (range: 42 to 84) years were analyzed. A total of 74 PIPAC and 5 PITAC procedures were performed. Tumor regression grade (TRG) 1 to 4 was observed in 75% of patients.

Major regression (TRG 3) or complete regression (TRG 4) was observed in 20% and 10%, respectively. PIPAC induced significant tumor regression in 51.7% of patients with a cumulative effect after repetitive PIPAC.

Researchers concluded that, “after prior abdominal surgery and systemic chemotherapy, repetitive PIPAC applications are feasible and safe for patients with end-stage MM.” Furthermore, “PIPAC induces significant histological regression of malignant mesothelioma in the majority of patients.” Median overall survival of 26.6 months from the first application and adverse events were also noted.

Study nurses collected clinical and follow-up data after the study to assess patients’ quality of life. The results showed a notable increase among patients in all functional scales such as cognitive functioning, emotional functioning, physical functioning, role functioning, and social functioning, as well as overall quality of life. In addition, reports BMC, “items of gastrointestinal toxicity” such as appetite loss, constipation, nausea and vomiting improved during PIPAC treatment, as did fatigue.

Because patients with recurrent mesothelioma have limited treatment options after surgery and standard chemotherapy with cisplatin and pemetrexed, PIPAC offers a promising new treatment pathway that has the potential to not only extend life, but to improve the quality of it as well.

If you have been diagnosed with mesothelioma, talk to your doctor about promising new treatments such as PIPAC. Although there is no cure for the disease, treatments such as this could be effective in treating your specific type of mesothelioma. Talk to your doctor today.

 

Sources

Giger-Pabst, U., and C. Demtröder. "Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for the Treatment of Malignant Mesothelioma." PubMed.gov. National Center for Biotechnology Information (NCBI), U.S. National Library of Medicine (NLM), 18 Apr. 2018. Web. 15 May 2018.

Giger-Pabst, Urs, Cédric Demtröder, Thomas A. Falkenstein, Mehdi Ouaissi, Thorsten O. Götze, Günther A. Rezniczek, and Clemens B. Tempfer. "Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for the Treatment of Malignant Mesothelioma." BMC Cancer. BioMed Central, 18 Apr. 2018. Web. 15 May 2018.