Feasibility and efficacy of intraperitoneal docetaxel administration as salvage chemotherapy for malignant gynaecological ascites

Abstract

Ovarian and endometrial cancers diagnosed at advanced stages are often associated with malignant ascites. This study aimed to determine the safety, feasibility and efficacy of intraperitoneal (IP) docetaxel (TXT) for the treatment of ascites. A phase I study, including nine patients, was undertaken to determine the maximum tolerable dose. Efficacy was retrospectively assessed in 18 patients treated with 40-70 mg/m(2) IP TXT between 2005 and 2012. In a phase I study, the dose was safely escalated to a maximum of 70 mg/m(2), at which level no patients had grade -3 haematological adverse events. In a retrospective study of 18 patients, seven had an Eastern Cooperative Oncology Group performance status of 3; 16 had prior paclitaxel administration and two, with doses of 40 and 70 mg/m(2), experienced a serological response and a decrease in paracentesis. Thus, palliative treatment of recurrent OC should be further studied with 40 mg/m(2) among more patients, and 70 mg/m(2) could be evaluated for first-line IP chemotherapy.

Docetaxel HIPEC Combined with Endostar versus Docetaxel HIPEC Alone in Treatment of Malignant Ascites：A Retrospective Study

“…Docetaxel is a semisynthetic taxane, which is widely used for NSCLC, breast cancer,gastric cancer,ovarian cancer,et al [17]. It showed nearly 1000 times higher area under the curve(AUC) with intraperitoneal injection compared with intravenous injection for peritoneal concentrations [18]. Also the peak concentration was approximately 200 times higher in the peritoneum than in the plasma [19,20].…”

Intraperitoneal delivery of platinum with in-situ crosslinkable hyaluronic acid gel for local therapy of ovarian cancer

“…With increasing awareness of the potential benefits, several drugs have been delivered IP for the therapy of peritoneal malignancies [14–16]; however, most of them are simple repurposing of IV drugs, not necessarily designed with special constraints for IP delivery in mind. Those requirements include (i) the biocompatibility of the material system--an important feature given the sensitivity of the peritoneal cavity to foreign insults [17], (ii) an optimum rate of degradation and absorption for an extended retention in the peritoneal cavity, and (iii) the ability to control the drug release for prolonging the local effect and attenuating systemic drug absorption.…”

Efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy for the treatment of malignant ascites: a midterm study of 36 patients

“… 1 MA patients normally have an unfavorable survival and a compromised quality of life (QoL) due to complicating abdominal distension or pain, dyspnea, malnutrition, and sepsis. 2 Surgical resection is thought to be unsuitable for these patients, while conventional palliative treatment modalities, such as conservative medical treatment, abdominocentesis, and systemic chemotherapy, show a minimal effect on the improvement of MA patients’ survival and QoL. 3 …”