Localized chemotherapy approaches and advanced drug delivery strategies: a step forward in the treatment of peritoneal carcinomatosis from ovarian cancer

Abstract

Peritoneal carcinomatosis (PC) is a common outcome of epithelial ovarian carcinoma and is the leading cause of death for these patients. Tumor location, extent, peculiarities of the microenvironment, and the development of drug resistance are the main challenges that need to be addressed to improve therapeutic outcome. The development of new procedures such as HIPEC (Hyperthermic Intraperitoneal Chemotherapy) and PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) have enabled locoregional delivery of chemotherapeutics, while the increasingly efficient design and development of advanced drug delivery micro and nanosystems are helping to promote tumor targeting and penetration and to reduce the side effects associated with systemic chemotherapy administration. The possibility of combining drug-loaded carriers with delivery via HIPEC and PIPAC represents a powerful tool to improve treatment efficacy, and this possibility has recently begun to be explored. This review will discuss the latest advances in the treatment of PC derived from ovarian cancer, with a focus on the potential of PIPAC and nanoparticles in terms of their application to develop new therapeutic strategies and future prospects.

Injectable Nanocomposite Hydrogels Improve Intraperitoneal Co-delivery of Chemotherapeutics and Immune Checkpoint Inhibitors for Enhanced Peritoneal Metastasis Therapy

“…The first-line therapy for OC with peritoneal metastasis is cytoreductive surgery followed by adjuvant chemotherapy . The chemotherapeutic regimen is in most cases a combination of carboplatin and paclitaxel (PTX) which can be administered systemically or intraperitoneally. , While these treatment modalities are, at least initially, effective, they subject patients to severe side effects (e.g., hematological and gastrointestinal adverse events) that often require the reduction of drug dosages, which may limit the activity of the therapeutic agents. , …”

“…5,6 While these treatment modalities are, at least initially, effective, they subject patients to severe side effects (e.g., hematological and gastrointestinal adverse events) that often require the reduction of drug dosages, which may limit the activity of the therapeutic agents. 7,8 Progress in the development of immune checkpoint blocking antibodies has led to more treatment options for OC. PD-1/PD-L1 blockade is considered one of the most promising strategies and has shown impressive clinical benefits in a wide range of cancers.…”