Combined Resection, Intraperitoneal Chemotherapy, and Whole Abdominal Radiation for the Treatment of Malignant Peritoneal Mesothelioma

Hesdorffer, Mary; Chabot, John A.; Keohan, Mary Louise; Fountain, Karen S.; Talbot, Susan; Gabay, Michelle; Valentin, Colette; Lee, Shing M.; Taub, Robert N.

doi:10.1097/coc.0b013e3180684181

Cited by 42 publications

(23 citation statements)

References 18 publications

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“…Intracavitary chemotherapy (Hesdorffer, Chabot, DeRosa, et al 2008;Hesdorffer, Chabot, Keohan, et al 2008; Van der Speeten, Stuart, Mahteme, et al 2009; , including the administration of hyperthermic drugs (van Ruth, Baas, et al 2003;van Ruth, van Tellingen, et al 2003;Richards et al 2006), has increased patient survival time by an average of only 6 months. Thus, there is a need for more effective treatment strategies (Zauderer and Krug 2011).…”

mentioning

confidence: 99%

A Multifunctional Mesothelin Antibody-tagged Microparticle Targets Human Mesotheliomas

Macura

Hillegass

Steinbacher

et al. 2012

J Histochem Cytochem.

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Pleural and peritoneal mesotheliomas (MMs) are chemoresistant tumors with no effective therapeutic strategies. The authors first injected multifunctional, acid-prepared mesoporous spheres (APMS), microparticles functionalized with tetraethylene glycol oligomers, intraperitoneally into rodents. Biodistribution of APMS was observed in major organs, peritoneal lavage fluid (PLF), and urine of normal mice and rats. After verification of increased mesothelin in human mesotheliomas injected into severe combined immunodeficient (SCID) mice, APMS were then functionalized with an antibody to mesothelin (APMS-MB) or bovine serum albumin (BSA), a nonspecific protein control, and tumor targeting was evaluated by inductively coupled plasma mass spectrometry and multifluorescence confocal microscopy. Some APMS were initially cleared via the urine over a 24 hr period, and small amounts were observed in liver, spleen, and kidneys at 24 hr and 6 days. Targeting with APMS-MB increased APMS uptake in mesenteric tumors at 6 days. Approximately 10% to 12% of the initially injected amount was observed in both spheroid and mesenteric MM at this time point. The data suggest that localized delivery of APMS-MB into the peritoneal cavity after encapsulation of drugs, DNA, or macromolecules is a novel therapeutic approach for MM and other tumors (ovarian and pancreatic) that overexpress mesothelin.

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mentioning

confidence: 99%

A Multifunctional Mesothelin Antibody-tagged Microparticle Targets Human Mesotheliomas

Macura

Hillegass

Steinbacher

et al. 2012

J Histochem Cytochem.

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“…Investigators at Columbia University Medical Center published their experience with this treatment approach in 2008 [27]. In this study, 27 patients with MPM were enrolled.…”

Section: Interventional Proceduresmentioning

confidence: 99%

Surgery for Peritoneal Mesothelioma

Turner

Varghese

Alexander

2011

Curr. Treat. Options in Oncol.

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Malignant peritoneal mesothelioma (MPM) is a rare, progressive, and ultimately fatal disease in almost all afflicted individuals. MPM is a cancer that arises diffusely from the serosa of the abdominal cavity and progresses almost exclusively in this region; understanding its characteristic tumor biology has been the reasoning behind the development of treatment strategies designed to control disease progression in the peritoneum. This principally includes operative cytoreduction and hyperthermic intra-operative perfusion of intraperitoneal chemotherapy (HIPEC). This approach has been administered either alone or in combination with early postoperative intraperitoneal chemotherapy (EPIC), or as a component of a more protracted multimodal approach employing initial debulking surgery, intraperitoneal chemotherapy, and whole abdominal radiotherapy. Median overall survivals of up to 7 years have been observed in series of patients selected for operative cytoreduction and HIPEC. Factors associated with good outcome are female gender, age less or equal to 60 years, and the ability to achieve a complete extirpation of all gross peritoneal disease. In patients with symptomatic ascites, complete palliation is achieved in almost all cases. However, this treatment strategy is not without complications and carries a morbidity of 25% and mortality up to 7%. Despite these risks, the best overall survival data have been associated with this surgical approach. At our institution, we advocate cytoreduction and HIPEC as the standard management for patients with MPM for whom operative cytoreduction appears possible and safe. We believe this treatment approach should be considered as the standard of care for patients with MPM.

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“…The initial excitement associated with the approval of pemetrexed and cisplatin has subsided, and the work of finding improved treatment options continues. Trials of multimodality therapy incorporating debulking surgery, intraperitoneal chemotherapy, and in some series whole abdominal radiation have resulted in long-term survival of a few selected patients [19,[23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Peritoneal Mesothelioma

Hesdorffer

Chabot

DeRosa

et al. 2008

Curr. Treat. Options in Oncol.

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Malignant peritoneal mesothelioma (MPM) is an aggressive neoplasm that rapidly spreads within the confines of the abdominal cavity to involve most accessible peritoneal and omental surfaces. Current treatment options are unsatisfactory, and new approaches are needed. Recent publications have reported improved survival with an intensive loco-regional treatment strategy including cytoreductive surgery (CRS) along with hyperthermic intraperitoneal chemotherapy (HIPEC). We have noted at our institution prolonged survival in selected patients after intensive multimodality treatment. Our most recently reported trial included initial laparatomy with omentectomy, resection of peritoneal implants, and placement of bilateral peritoneal Portacath; repeated courses of intraperitoneal chemotherapy with doxorubicin, cisplatin, and interferon gamma; second-look laparotomy; and intraoperative hyperthermic perfusion with mitomycin and cisplatin, followed by whole abdominal radiation. To date there have been no universally accepted treatments for MPM. Unless referred to a specialty center, patients are routinely treated with pemetrexed and cisplatin which has been shown to increase survival in pleural mesothelioma.

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Combined Resection, Intraperitoneal Chemotherapy, and Whole Abdominal Radiation for the Treatment of Malignant Peritoneal Mesothelioma

Abstract: Based on the results of this study, intensive multimodality therapy appears feasible and effective in this group of patients.

Cited by 42 publications

References 18 publications

A Multifunctional Mesothelin Antibody-tagged Microparticle Targets Human Mesotheliomas

A Multifunctional Mesothelin Antibody-tagged Microparticle Targets Human Mesotheliomas

Surgery for Peritoneal Mesothelioma

Peritoneal Mesothelioma

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