Cellular Immunoprofile of Peritoneal Environment During a HIPEC Procedure

Franko, Jan; Brahmbhatt, Rushin D.; Tee, May C.; Raman, Shankar; Ferrel, Benjamin; Gorvet, Marc; Andres, Matthew

doi:10.1245/s10434-020-08870-3

Cited by 8 publications

(5 citation statements)

References 43 publications

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“…Some studies were published in high-ranked journals, such as The New England Journal of Medicine (NCT00426257) [ 24 ], JAMA Surgery (NCT01091636) [ 25 ], Lancet Oncology (NCT00769405, NCT01226394, NCT01835041) [ 26 , 27 , 28 ], or the Lancet Gastroenterology Hepatology (NCT02231086) [ 29 ]. Most trials were published in the Annals of Surgical Oncology (NCT00458809, NCT02891447, NCT03230240, NCT02575859, NCT02863471) [ 30 , 31 , 32 , 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

Current Research and Development in Hyperthermic Intraperitoneal Chemotherapy (HIPEC)—A Cross-Sectional Analysis of Clinical Trials Registered on ClinicalTrials.gov

Ukegjini

Guidi

Lehmann

et al. 2023

Cancers

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Introduction: Over the past two decades, cytoreductive surgery and HIPEC has improved outcomes for selected patients with peritoneal metastasis from various origins. This is a cross-sectional study with descriptive analyses of HIPEC trials registered on ClinicalTrials.gov. This study aimed to characterize clinical trials on HIPEC registered on ClinicalTrials.gov with the primary objective of identifying a trial focus and to examine whether trial results were published. Methods: The search included trials registered from 1 January 2001 to 14 March 2022. We examined the associations of exposure variables and other trial features with two primary outcomes: therapeutic focus and results reporting. Results: In total, 234 clinical trials were identified; 26 (11%) were already published, and 15 (6%) trials have reported their results but have not been published as full papers. Among ongoing nonpublished trials, 81 (39%) were randomized, 30 (14%) were blinded, n = 39 (20%) were later phase trials (i.e., phases 3 and 4), n = 152 (73%) were from a single institution, and 91 (44%) had parallel groups. Most of the trials were recruiting at the time of this analysis (75, 36%), and 39 (20%) were completed but had yet to publish results. In total, 68% of the trials focused on treatment strategies, and 53% investigated the oncological outcome. The most studied neoplasms for HIPEC trials were peritoneally metastasized colorectal cancer (32%), gastric cancer (29%), and ovarian cancer (26%). Twenty different drugs were analyzed in these clinical trials. Conclusions: Many study results are awaited from ongoing HIPEC trials. Most HIPEC trials focused on gastric, colorectal, or ovarian cancer. Many clinical trials were identified involving multiple entities and chemotherapeutic agents.

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Section: Resultsmentioning

confidence: 99%

Current Research and Development in Hyperthermic Intraperitoneal Chemotherapy (HIPEC)—A Cross-Sectional Analysis of Clinical Trials Registered on ClinicalTrials.gov

Ukegjini

Guidi

Lehmann

et al. 2023

Cancers

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“…The cause of this phenomenon could be the removal of tumor mass-producers of cytokines after cytoreduction and a decrease in TNF expression by intra-abdominal microenvironmental cellular components, particularly macrophages, under the influence of hourly hyperthermia. We previously showed that peritoneal AAMs in OC are similar in their properties to TAMs [9,16]. TAM/AAM supports cancer cell survival by secreting proinflammatory cytokines (TNF, IL-6), increasing neoangiogenesis (VEGF), converting TGF-β and secreting IGF1, consequently stimulating cell proliferation and potentiating tumor complex implantation in the abdominal cavity [24].…”

Section: Discussionmentioning

confidence: 99%

“…[7,8]. The perfusate samples taken from patients with OC after cytoreduction and HIPEC revealed changes in the ratio of T-lymphocyte subpopulations (CD4/CD8) depending on their duration [9]. However, out of all cellular components that form the overall landscape of intra-abdominal homeostasis, mesothelial cells and peritoneal macrophages have the greatest importance.…”

Section: Introductionmentioning

confidence: 99%

Cytokine-Modulating Influence of Hipec on the Intraperitoneal Homeostasis Formation in Patients With Ovarian Cancer

Fetsych,

Igumentseva,

Ferneza

et al. 2023

Proc Shevchenko Sci Soc Med Sci

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Background: Ovarian cancer (OC) has the greatest mortality rate among oncogynecological diseases. Most cases are diagnosed at the peritoneal dissemination stage, resulting in radical treatment. Most cases (75%) are diagnosed in III-IV stages at the stage of peritoneal dissemination, making the radical treatment impossible. Intraoperative hyperthermic intraperitoneal chemoperfusion (HIPEC), which has ceased to be an experimental technique over the past decade, is increasingly used among the methods of combating peritoneal carcinomatosis and demonstrates an increase in recurrence-free and overall survival in advanced stages of OC. Nevertheless, certain pathophysiological aspects of the effect of HIPEC on intra-abdominal homeostasis, and therefore on the further course of the disease, have not been elucidated. However, understanding this effect may be the key to the successful application of HIPEC and predicting its efficacy in each case of OC. Objectives: To access changes in intraperitoneal homeostasis in patients with advanced OC after HIPEC procedure (as a stage of cytoreductive surgery); in particular, to evaluate changes of TNF and TGF-β expression under the influence of HIPEC and systemic chemotherapy in the OC microenvironment. Materials and methods: The study included 33 OC patients treated at Lviv Regional Cancer Centre in 2016–2020. Twelve of them received HIPEC. The primary tumor cultures and primary cultures of peritoneal mesothelium and macrophages were obtained for all patients. The cytokines TNF and TGF-β activity were determined in their conditional media. Results: The decrease of TNF and TGF-β concentrations in the drainage exudate after HIPEC was revealed compared with the same parameters in the ascitic fluid before the operation. One-hour hyperthermia of the primary culture of peritoneal ascites-associated macrophages of recurrent OC patients decreased the TNF level in conditional media. A decline was found in 10 out of 12 cases. Conclusions: HIPEC has a cytokine-modulating effect on the intra-abdominal homeostasis of patients with OC, suppressing TNF expression by peritoneal macrophages. Reduced activity of TNF in supernatants of OC primary tumor cultures was associated with higher sensitivity to chemotherapy.

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“…Very little is known on the effect of HIPEC on the TME of PM, and on the peritoneal immune environment. Franko and coworkers sampled peritoneal fluid during HIPEC procedures at different time intervals between 0 and 90 min [46] They did not observe significant changes in the number of peritoneal NK cells, CD4/CD8 ratio, or granulocyte/lymphocyte ratio during the course of HIPEC.…”

Section: Use Of Hyperthermiamentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy: A Critical Review

Ceelen

Demuytere

Hingh

2021

Cancers

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With increasing awareness amongst physicians and improved radiological imaging techniques, the peritoneal cavity is increasingly recognized as an important metastatic site in various malignancies. Prognosis of these patients is usually poor as traditional treatment including surgical resection or systemic treatment is relatively ineffective. Intraperitoneal delivery of chemotherapeutic agents is thought to be an attractive alternative as this results in high tumor tissue concentrations with limited systemic exposure. The addition of hyperthermia aims to potentiate the anti-tumor effects of chemotherapy, resulting in the concept of heated intraperitoneal chemotherapy (HIPEC) for the treatment of peritoneal metastases as it was developed about 3 decades ago. With increasing experience, HIPEC has become a safe and accepted treatment offered in many centers around the world. However, standardization of the technique has been poor and results from clinical trials have been equivocal. As a result, the true value of HIPEC in the treatment of peritoneal metastases remains a matter of debate. The current review aims to provide a critical overview of the theoretical concept and preclinical and clinical study results, to outline areas of persisting uncertainty, and to propose a framework to better define the role of HIPEC in the treatment of peritoneal malignancies.

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Cellular Immunoprofile of Peritoneal Environment During a HIPEC Procedure

Cited by 8 publications

References 43 publications

Current Research and Development in Hyperthermic Intraperitoneal Chemotherapy (HIPEC)—A Cross-Sectional Analysis of Clinical Trials Registered on ClinicalTrials.gov

Current Research and Development in Hyperthermic Intraperitoneal Chemotherapy (HIPEC)—A Cross-Sectional Analysis of Clinical Trials Registered on ClinicalTrials.gov

Cytokine-Modulating Influence of Hipec on the Intraperitoneal Homeostasis Formation in Patients With Ovarian Cancer

Hyperthermic Intraperitoneal Chemotherapy: A Critical Review

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