Pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for gastric cancer with peritoneal metastases: A systematic review by the PIPAC UK collaborative

Case, A.N.; Prosser, S.; Peters, Christopher J.; Adams, Rachel; Gwynne, S.

doi:10.1016/j.critrevonc.2022.103846

Cited by 11 publications

(10 citation statements)

References 53 publications

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“…Second, there is some evidence indicating the potency of PIPAC. A recent systematic review summarized current evidence and suggested that PIPAC can lead to improved long-term outcomes with a median OS of 8-19.1 months [ 13 ]. These results are even more encouraging, when the fact that the majority of included patients were already intensively pre-treated with sometimes several different lines of systemic chemotherapy [ 13 ], is taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review summarized current evidence and suggested that PIPAC can lead to improved long-term outcomes with a median OS of 8-19.1 months [ 13 ]. These results are even more encouraging, when the fact that the majority of included patients were already intensively pre-treated with sometimes several different lines of systemic chemotherapy [ 13 ], is taken into consideration. Although, current studies have many limitations, including heterogeneity of treatment protocols (PIPAC alone vs. bidirectional treatment) and measured outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Although, current studies have many limitations, including heterogeneity of treatment protocols (PIPAC alone vs. bidirectional treatment) and measured outcomes. Also, the majority of them are retrospective [ 13 ]. Thus, there is a need for new prospective phase II studies.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, PIPAC can be applied repeatedly and biopsies can be taken during the procedure for objective assessment of tumor regression [ 11 , 12 ]. PIPAC can be used as a single method for treatment (“unidirectional”) or in a “bidirectional” manner when it is combined with systemic chemotherapy [ 13 ]. The bidirectional approach seems rational because intravenously applied chemotherapy may improve subperitoneal drug accumulation and also treat circulating tumor cells and systemic micrometastases [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study

Luksta,

Bausys,

Bickaite

et al. 2023

BMC Cancer

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Background Gastric cancer (GC) remains among the most common and most lethal cancers worldwide. Peritoneum is the most common site for distant dissemination. Standard treatment for GC peritoneal metastases (PM) is a systemic therapy, but treatment outcomes remain very poor, with median overall survival ranging between 3-9 months. Thus, novel treatment methods are necessary. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is the most novel technique for intraperitoneal chemotherapy. Some preliminary data suggest PIPAC can achieve improved long-term outcomes in patients with GC PM, especially when used in combination with systemic chemotherapy. However, there is a lack of data from well-design prospective studies that would confirm the efficacy of PIPAC and systemic therapy combination for first-line treatment. Methods This study is an investigator-initiated single-arm, phase II trial to investigate the efficacy of PIPAC combined with systemic FOLFOX (5-fluorouracil, oxaliplatin, leucovorin) as a first-line treatment for GC PM. The study is conducted in 2 specialized GC treatment centers in Lithuania. It enrolls GC patients with histologically confirmed PM without prior treatment. The treatment protocol consists of PIPAC with cisplatin (10.5 mg/m2 body surface in 150 mL NaCl 0.9%) and doxorubicin (2.1 mg/m2 in 50 mL NaCl 0.9%) followed by 2 cycles of FOLFOX every 6–7 weeks. In total 3 PIPACs and 6 cycles of FOLFOX will be utilized. The primary outcome of the study is the objective response rate (ORR) according to RECIST v. 1.1 criteria (Eisenhauer et al., Eur J Cancer 45:228–47) in a CT scan performed 7 days after the 4th cycle of FOLFOX. Secondary outcomes include ORR after all experimental treatment, PIPAC characteristics, postoperative morbidity, histological and biochemical response, ascites volume, quality of life, overall survival, and toxicity. Discussion This study aims to assess PIPAC and FOLFOX combination efficacy for previously untreated GC patients with PM. Trial registration NCT05644249. Registered on December 9, 2022.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study

Luksta,

Bausys,

Bickaite

et al. 2023

BMC Cancer

View full text Add to dashboard Cite

show abstract

“…Moreover, PIPAC can be applied repeatedly and biopsies can be taken during the procedure for objective assessment of tumor regression [11,12]. PIPAC can be used as a single method for treatment ("unidirectional") or in a "bidirectional" manner when it is combined with systemic chemotherapy [13]. The bidirectional approach seems rational because intravenously applied chemotherapy may improve subperitoneal drug accumulation and also treat circulating tumor cells and systemic micrometastases [14].…”

Section: Introductionmentioning

confidence: 99%

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study

Lukšta

Baušys²,

Bickaite

et al. 2023

Preprint

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Background Gastric cancer (GC) remains among the most common and most lethal cancers worldwide. Peritoneum is the most common site for distant dissemination. Standard treatment for GC peritoneal metastases (PM) is a systemic therapy, but treatment outcomes remain very poor, with median overall survival ranging between 3–9 months. Thus, novel treatment methods are necessary. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is the most novel technique for intraperitoneal chemotherapy. Some preliminary data suggest PIPAC can achieve improved long-term outcomes in patients with GC PM, especially when used in combination with system chemotherapy. However, there is a lack of data from well-design prospective studies that would confirm the efficacy of PIPAC and systemic therapy combination for first-line treatment. Methods This study is an investigator-initiated single-arm, phase II trial to investigate the efficacy of PIPAC combined with systemic FOLFOX (5-fluorouracil, oxaliplatin, leucovorin) as a first-line treatment for GC PM. The study is conducted in 2 specialized GC treatment centers in Lithuania. It enrolls GC patients with histologically confirmed PM without prior treatment. The treatment protocol consists of PIPAC with cisplatin (10.5 mg/m2 body surface in 150 mL NaCl 0.9%) and doxorubicin (2.1 mg/m2 in 50 mL NaCl 0.9%) followed by 2 cycles of FOLFOX every 6–7 weeks. In total 3 PIPACs and 6 cycles of FOLFOX will be utilized. The primary outcome of the study is the objective response rate (ORR) according to RECIST v. 1.1 criteria [20] in a CT scan performed 7 days after the 4th cycle of FOLFOX. Secondary outcomes include ORR after all experimental treatment, PIPAC characteristics, postoperative morbidity, histological and biochemical response, ascites volume, quality of life, overall survival, and toxicity. Discussion This study aims to assess PIPAC and FOLFOX combination efficacy for previously untreated GC patients with PM. Trial registration NCT05644249. Registered on December 9, 2022.

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Emerging Treatment Modalities for Gastric Cancer With Macroscopic Peritoneal Metastases: A Systematic Review

Gül,

Alberto,

Annika

et al. 2024

Journal of Surgical Oncology

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Gastric cancer with macroscopic peritoneal metastases represents a major therapeutic challenge and is associated with a poor prognosis. This review aims to evaluate the efficacy and safety of new treatment modalities. A systematic search of PubMed was conducted to identify studies published between January 2014 and April 2024. Inclusion criteria were trials investigating novel therapies for gastric cancer with peritoneal metastases. Data on treatment efficacy, survival outcomes, and side effects were extracted.

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Pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for gastric cancer with peritoneal metastases: A systematic review by the PIPAC UK collaborative

Cited by 11 publications

References 53 publications

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study

Emerging Treatment Modalities for Gastric Cancer With Macroscopic Peritoneal Metastases: A Systematic Review

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