Much of the research into mesothelioma treatments focuses on treating pleural mesothelioma, as this is the most common form of the disease. However, a new treatment for peritoneal mesothelioma is currently undergoing clinical trials.
The treatment is called Pressurised Intraperitoneal Aerosol Chemotherapy (PIPAC). It aims to deliver treatment directly to the site of the tumour in a minimally invasive way.
This revolutionary treatment involves chemotherapy drugs, in gas form, essentially being sprayed directly onto the site of the cancer through a small incision in the skin. A laparoscope is used to ensure the correct location is treated.
Although the treatment is still in clinical trials, it has already been used on thousands of cancer patients throughout Europe.
How successful has the treatment been so far?
Researchers have reviewed 29 recurrent mesothelioma patients who received PIPAC treatment. In 20 of the patients who had had more than two PIPAC or PITAC (a similar procedure for the chest cavity) treatments, 75% showed some regression in their tumours. For 20% of those patients, the regression was major with 10% of them showing “complete regression” of the mesothelioma tumours.
The results show that the treatment is working on mesothelioma, and only two of the patients suffered serious complications.
This is an exciting development in the treatment of mesothelioma, as PIPAC appears to have several advantages over other treatment options. For example:
- It is minimally invasive so the risks associated with open surgery are reduced.
- Patients can receive PIPAC up to eight times.
- Using chemotherapy drugs as a gas rather than a liquid can help them be absorbed better, potentially helping them to become more effective.
- PIPAC can be a treatment option for mesothelioma patients who are not suitable for cytoreductive surgery.
PIPAC has shown a “significant histological regression of malignant mesothelioma in peritoneal patients.” However, there are still questions over whether this would have the same effect for pleural mesothelioma patients and further research and development is needed.
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Giger-Pabst, U, et al, “Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for the treatment of malignant mesothelioma”, April 18, 2018, BMC Cancer
Nowacki, M, et al, “Multicenter comprehensive methodological and technical analysis of 832 pressurized intraperitoneal aerosol chemotherapy (PIPAC) interventions performed in 349 patients for peritoneal carcinomatosis treatment: An international survey study”, February 22, 2018, European Journal of Surgical Oncology, Epub ahead of print
“Peritoneal mets. New, local treatment: PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy”, Colon Talk, December 12, 2016