Peritoneal mesothelioma is an incredibly rare form of cancer that affects the peritoneum, or abdominal lining. It is not entirely understood how exposure to asbestos causes this type of cancer, but scientists and researchers theorize that ingested asbestos fibers work themselves into the peritoneal cavity, or if inhaled, are transported through the lymph node system. Only 100 to 500 cases are diagnosed in the US each year, making up less than 30% of all mesothelioma cases.
Standard treatment has been liquid intraperitoneal chemotherapy, but European researchers have been developing and testing a new method of administering the treatment that has a more targeted approach. Pressurized intraperitoneal aerosol chemotherapy – or PIPAC – is a method that sprays aerosol chemotherapy into the abdomen. The latest study, published in BMC Cancer found that when PIPAC was administered, patients not only saw their tumors decrease in size, but found that their symptoms had lessened. Researchers believe that PIPAC can be a more effective way of treating peritoneal mesothelioma because the treatment is more concentrated and can better saturate the invasive cancer cells while leaving healthy cells alone.
The study consisted of 24 peritoneal mesothelioma patients who had previously had surgery or traditional chemotherapy. These patients received PIPAC treatments (a combination of cisplatin and doxorubician) on average of two or three times, delivered straight to the abdomen. In this method, doctors pump aerosol chemotherapy into the abdomen. As the abdomen inflates, the pressurized treatment is able to spread and weaken/kill the tumors and cancer cells. While 15 out of the 24 peritoneal mesothelioma patients did experience tumor shrinkage, 43 percent of those in the study did experience negative side effects such as kidney infection/ injury and vomiting. One patient passed away from kidney failure after undergoing a second round of treatment.
PIPAC is similar to a treatment in the United States, HIPEC, which stands for hyperthermic intraperitoneal chemotherapy. HIPEC uses liquid chemotherapy that is heated and administered intravenously like traditional chemotherapy. This method is known to be effective, but is also known to negatively affect healthy cells. PIPAC is not an available treatment in the United States but can be found in on-going clinical trials in Europe, South America, Asia , and Australia. However, the United States continues to focus on HIPEC after improvements to the overall five year survival rate recently increased after multiple studies.
Source:
Urs, Giger-Pabst, et. al. “Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for the Treatment of Malignant Mesothelioma” BMC Cancer (January 10, 2018). [Link]
