Clinical Outcome for Patients Managed with Low-Dose Cisplatin and Doxorubicin Delivered as Pressurized Intraperitoneal Aerosol Chemotherapy for Unresectable Peritoneal Metastases of Gastric Cancer

Sindayigaya, Rémy; Dogan, Can; Demtröder, C.; Fischer, Britta; Karam, Elias; Buggisch, Jonathan R.; Tempfer, Clemens; Lecomte, Thierry; Ouaïssi, Mehdi; Giger‐Pabst, Urs

doi:10.1245/s10434-021-10860-y

Cited by 21 publications

(24 citation statements)

References 36 publications

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“…They detected a major or complete response in 33% and 22% of the patients at the third PIPAC, while none and 3%, respectively, had no response to treatment [ 53 ]. In a retrospective study on patients with gastric cancer, baseline PRGS were not available, but a major or complete response was seen in 27 (19%) and a minor or no response in 9 (6%) patients at the third PIPAC [ 54 ]. The authors concluded that the completion of more than two PIPACs had prognostic value, while PRGS did not.…”

Section: Resultsmentioning

confidence: 99%

Response Evaluation in Patients with Peritoneal Metastasis Treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)

Roensholdt

Detlefsen

Mortensen

et al. 2023

JCM

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Pressurized intraperitoneal aerosol chemotherapy (PIPAC) directed therapy emerged as a treatment of peritoneal metastasis (PM) a decade ago. The response assessment of PIPAC is not uniform. This narrative review describes non-invasive and invasive methods for response evaluation of PIPAC and summarizes their current status. PubMed and clinicaltrials.gov were searched for eligible publications, and data were reported on an intention-to-treat basis. The peritoneal regression grading score (PRGS) showed a response in 18–58% of patients after two PIPACs. Five studies showed a cytological response in ascites or peritoneal lavage fluid in 6–15% of the patients. The proportion of patients with malignant cytology decreased between the first and third PIPAC. A computed tomography showed stable or regressive disease following PIPAC in 15–78% of patients. The peritoneal cancer index was mainly used as a demographic variable, but prospective studies reported a response to treatment in 57–72% of patients. The role of serum biomarkers of cancer or inflammation in the selection of candidates for and responders to PIPAC is not fully evaluated. In conclusion, response evaluation after PIPAC in patients with PM remains difficult, but PRGS seems to be the most promising response evaluation modality.

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Section: Resultsmentioning

confidence: 99%

Response Evaluation in Patients with Peritoneal Metastasis Treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)

Roensholdt

Detlefsen

Mortensen

et al. 2023

JCM

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“…The technique is safe and potentially cost-effective ( 73 , 74 ). Early survival estimates from small trials of PIPAC plus chemotherapy have shown efficacy in comparison to chemotherapy alone ( 75 ), as well as responses conferring eligibility for CRS-HIPEC trials ( 76 ). Larger-scale trials are underway ( 71 , 77 ).…”

Section: Future Directionsmentioning

confidence: 99%

Gastric adenocarcinoma peritoneal carcinomatosis: a narrative review

Green¹,

Davis²

2022

Dig Med Res

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Background and Objective: To describe the diagnosis, workup, management, and areas of active research for peritoneal carcinomatosis (PC) arising from gastric adenocarcinoma (GA). The peritoneum is a common site of metastasis and recurrence for GA. Unlike other cancers of the peritoneal surface, there are no approved locoregional techniques to address peritoneal disease in GA. PC has a unique natural history, therapeutic response, and outlook that sets it apart from solid organ metastases. Methods: A search of PubMed and Google Scholar databases was performed for the terms “Gastric Adenocarcinoma Peritoneal Carcinomatosis” for English articles published between 2000 and October, 2021. A narrative review was undertaken to summarize literature pertaining to current diagnosis and management strategy of PC from GA. Future directions of diagnosis and treatment were discussed, including intraperitoneal chemotherapy and molecular diagnosis. Key Content and Findings: Incidence of carcinomatosis varies between Asia and Western populations, driving important differences in therapeutic algorithms and clinical trial eligibility. Determination of the extent of PC is a diagnostic challenge, with surgical staging as the most important modality. Systemic chemotherapy is the standard of care for patients with carcinomatosis. Intraperitoneal chemotherapy holds promise for patients with PC, but techniques are still considered experimental due to the paucity of data demonstrating improved survival. Conclusions: PC from gastric cancer represents both a significant clinical challenge and an area of great therapeutic potential.

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“…However, the majority will have extensive disease that prevents this strategy. 1 A theory that tries to explain the poor prognosis and the lack of a valid therapeutic option for PM is called the 'plasmaperitoneal barrier'. 2 This phenomenon is similar to the blood-brain barrier, in which the diffusion of systemic drugs is limited.…”

mentioning

confidence: 99%

“…However, in patients with good response, the number of sessions can be extended. 1 Due to the selection bias and lack of randomized trials, it is impossible to properly appraise the survival benefits of this approach. However, the results have been encouraging, with an objective tumor response according to the histological Peritoneal Regression Grading Score of around 70% 4 and, in some patients, with a reduction in PM that allows subsequent cytoreduction surgery and HIPEC.…”

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confidence: 99%

The Implementation of a PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) Program in Portugal

Bouca-Machado

Aral

Meireles³

et al. 2022

Acta Med Port

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Clinical Outcome for Patients Managed with Low-Dose Cisplatin and Doxorubicin Delivered as Pressurized Intraperitoneal Aerosol Chemotherapy for Unresectable Peritoneal Metastases of Gastric Cancer

Cited by 21 publications

References 36 publications

Response Evaluation in Patients with Peritoneal Metastasis Treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)

Response Evaluation in Patients with Peritoneal Metastasis Treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)

Gastric adenocarcinoma peritoneal carcinomatosis: a narrative review

The Implementation of a PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) Program in Portugal

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