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Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study

Taxanes have a favorable pharmacokinetic profile for intraperitoneal application. We report our initial experience with taxane-PIPAC (pressurized intraperitoneal chemotherapy) for unresectable peritoneal metastases from different primary sites in terms of safety, feasibility, response rate, and conv...

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Autores principales: Mehta, Sanket, Kammar, Praveen, Patel, Ankita, Goswami, Gaurav, Shaikh, Sakina, Sukumar, Vivek, Trivedi, Esha, Bhatt, Aditi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer India 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451111/
https://www.ncbi.nlm.nih.gov/pubmed/36091624
http://dx.doi.org/10.1007/s13193-022-01641-4
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author Mehta, Sanket
Kammar, Praveen
Patel, Ankita
Goswami, Gaurav
Shaikh, Sakina
Sukumar, Vivek
Trivedi, Esha
Bhatt, Aditi
author_facet Mehta, Sanket
Kammar, Praveen
Patel, Ankita
Goswami, Gaurav
Shaikh, Sakina
Sukumar, Vivek
Trivedi, Esha
Bhatt, Aditi
author_sort Mehta, Sanket
collection PubMed
description Taxanes have a favorable pharmacokinetic profile for intraperitoneal application. We report our initial experience with taxane-PIPAC (pressurized intraperitoneal chemotherapy) for unresectable peritoneal metastases from different primary sites in terms of safety, feasibility, response rate, and conversion to resectability. In this retrospective study, PIPAC was performed alone or in combination with systemic chemotherapy. Paclitaxel was used as a single agent, whereas docetaxel was used in combination with cisplatin-adriamycin or oxaliplatin-adriamycin. From December 2019 to December 2021, 47 patients underwent 82 PIPAC procedures (1 PIPAC in 55.3%, 2 in 29.7%, 3 in 14.8%). The most common primary sites were ovarian cancer (31.9%), gastric cancer (23.4%), and colorectal cancer (21.2%). Docetaxel-cisplatin-adriamycin was used in 33 (70.2%) patients, docetaxel-oxaliplatin-adriamycin in 12 (25.5%), and paclitaxel alone in 2 (4.2%) patients. Grade 1–2 complications were observed in 24 (51%) and grade 3–4 complications in 6 (12.7%) patients (8.5% of 82 PIPACs). 16/47 (34.0%) patients had a clinical response to PIPAC. The mean PCI was 25.9 ± 9.2 for the first PIPACs and 22.4 ± 9 for the subsequent PIPACs with an average reduction of 3.6 points [change in PCI ranged from − 14 to + 8]. The PRGS was 1/2 in 4/47 (8.5%) patients (19.0% patients with > 1 PIPAC). A reduction in ascites was observed in 35.4% presenting with ascites. Nine (19.1%) patients had conversion to operability leading to a subsequent cytoreductive surgery in 8 (17%) patients. PIPAC with docetaxel is feasible and safe. The role of PIPAC with both docetaxel and paclitaxel either alone or in combination with other drugs should be investigated in prospective studies.
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spelling pubmed-94511112022-09-07 Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study Mehta, Sanket Kammar, Praveen Patel, Ankita Goswami, Gaurav Shaikh, Sakina Sukumar, Vivek Trivedi, Esha Bhatt, Aditi Indian J Surg Oncol Original Article Taxanes have a favorable pharmacokinetic profile for intraperitoneal application. We report our initial experience with taxane-PIPAC (pressurized intraperitoneal chemotherapy) for unresectable peritoneal metastases from different primary sites in terms of safety, feasibility, response rate, and conversion to resectability. In this retrospective study, PIPAC was performed alone or in combination with systemic chemotherapy. Paclitaxel was used as a single agent, whereas docetaxel was used in combination with cisplatin-adriamycin or oxaliplatin-adriamycin. From December 2019 to December 2021, 47 patients underwent 82 PIPAC procedures (1 PIPAC in 55.3%, 2 in 29.7%, 3 in 14.8%). The most common primary sites were ovarian cancer (31.9%), gastric cancer (23.4%), and colorectal cancer (21.2%). Docetaxel-cisplatin-adriamycin was used in 33 (70.2%) patients, docetaxel-oxaliplatin-adriamycin in 12 (25.5%), and paclitaxel alone in 2 (4.2%) patients. Grade 1–2 complications were observed in 24 (51%) and grade 3–4 complications in 6 (12.7%) patients (8.5% of 82 PIPACs). 16/47 (34.0%) patients had a clinical response to PIPAC. The mean PCI was 25.9 ± 9.2 for the first PIPACs and 22.4 ± 9 for the subsequent PIPACs with an average reduction of 3.6 points [change in PCI ranged from − 14 to + 8]. The PRGS was 1/2 in 4/47 (8.5%) patients (19.0% patients with > 1 PIPAC). A reduction in ascites was observed in 35.4% presenting with ascites. Nine (19.1%) patients had conversion to operability leading to a subsequent cytoreductive surgery in 8 (17%) patients. PIPAC with docetaxel is feasible and safe. The role of PIPAC with both docetaxel and paclitaxel either alone or in combination with other drugs should be investigated in prospective studies. Springer India 2022-09-07 2023-06 /pmc/articles/PMC9451111/ /pubmed/36091624 http://dx.doi.org/10.1007/s13193-022-01641-4 Text en © The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
spellingShingle Original Article
Mehta, Sanket
Kammar, Praveen
Patel, Ankita
Goswami, Gaurav
Shaikh, Sakina
Sukumar, Vivek
Trivedi, Esha
Bhatt, Aditi
Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study
title Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study
title_full Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study
title_fullStr Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study
title_full_unstemmed Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study
title_short Feasibility and Safety of Taxane-PIPAC in Patients with Peritoneal Malignancies—a Retrospective Bi-institutional Study
title_sort feasibility and safety of taxane-pipac in patients with peritoneal malignancies—a retrospective bi-institutional study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451111/
https://www.ncbi.nlm.nih.gov/pubmed/36091624
http://dx.doi.org/10.1007/s13193-022-01641-4
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