From the blog

Why Patients Quit PIPAC for Mesothelioma

Published: June 30, 2023

PIPAC, or pressurized intraperitoneal aerosol chemotherapy, is showing promising results for mesothelioma, but patients don’t finish all their sessions. This is a problem because the patients then limit the effectiveness of their treatment. Researchers in France decided to figure out why patients are quitting their treatments early.

Mesothelioma is a rare cancer mainly caused by asbestos exposure. Asbestos is a fibrous mineral that was used for its heat and fire-resistant properties. Many people were exposed and didn’t even know they were putting their lives in danger just trying to make a living. Once asbestos fibers are inhaled, they become lodged in human tissue like the lungs, pleura (mesothelium that covers the lungs), and peritoneum (mesothelium that covers the abdomen). Once inhaled, it can take decades for the fibers to cause DNA changes in cells, which then leads to cancer. There are multiple clinical trials for mesothelioma, but there are also standard treatments as well including the combination of chemotherapy, radiation, and surgery. The treatment, known as multimodal therapy, can be helpful but it is not a cure for the cancer.

PIPAC has been in development for the past 10 years. It is recommended that patients who receive PIPAC receive at least three procedures, each time four to six weeks apart. Researchers wanted to know why patients stopped PIPAC early, so they looked at 26 articles to see explanations on why patients stopped treatment. There was data on 1,352 patients who received PIPAC. More than half did not receive the recommended three treatment sessions. Researchers found multiple reasons for patients stopping therapy including cancer becoming worse (most patients), death, personal preference, and side effects. Some of the patients who were undergoing the therapy stopped to receive a different treatment. Some patients also had to deal with auxiliary medical issues like lung infections.

More research is needed not only for PIPAC, but for other treatments for mesothelioma. Mesothelioma is a hard cancer to treat and current treatments only offer limited survival and quality of life benefits. If more research is conducted, new treatments could be available for mesothelioma that could potentially one day cure the disease. This is why research is so important. Without it, treatment for mesothelioma and other hard to treat cancers would not be where it is today.

Anne-Cecile Ezanno et al., “Pressurized intraperitoneal aerosol chemotherapy, reasons for interrupting treatment: a systematic review of the literature” Pleura Peritoneum (June 2023). [Link]
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