The challenge of drug delivery to the peritoneum
Peritoneal Cancer is most often a complication of primary cancers of various gastro-intestinal or gynecologic origins. It is usually the last stage of these cancers and all patients die within months. Because of the low perfusion index of the pleura and peritoneum, these organs are hard to reach for an intravenously injected drug. 95% of the patients receive systemic intravenous chemotherapy but less than 5% of the injected chemotherapy reaches the target point. Over 95% of the chemotherapy remains in the patient’s bloodstream, causing well known and sometimes severe side effects.
A technical solution exists that optimizes drug delivery for improved clinical outcomes
The solution to effectively delivering drugs to the target region is PIPAC (Pressurized Intra-Peritoneal Aerosol Chemotherapy). PIPAC is a 45-minute laparoscopic, minimally invasive procedure during which chemotherapy is administered under pressure as an aerosol. Less drug is needed and the side effects are thus reduced. The combined aerosol form and pressure improve the pharmacology and pharmacodynamics of anti-cancer drugs significantly, resulting in an optimal, homogenous spatial distribution of the chemotherapy agents. Close to 100% of the drugs aerosolized reach the target. The side effects are minimal. PIPAC is well tolerated and performed as an outpatient procedure in many countries. A growing body of evidence (over 250 peer-reviewed publications) supports safety and efficacy of this novel anti-cancer approach.