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Intraperitoneal chemotherapy for peritoneal metastases : an expert opinion

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Abstract
Introduction: The rationale for intraperitoneal (IP) drug delivery for patients with peritoneal metastases (PM) is based on the pharmacokinetic advantage resulting from the peritoneal-plasma barrier, and on the potential to adequately treat small, poorly vascularized PM. Despite a history of more than three decades, many aspects of IP drug delivery remain poorly studied. Areas covered: We outline the anatomy and physiology of the peritoneal cavity, including the pharmacokinetics of IP drug delivery. We discuss transport mechanisms governing tissue penetration of IP chemotherapy, and how these are affected by the biomechanical properties of the tumor stroma. We provide an overview of the current clinical evidence on IP chemotherapy in ovarian, colorectal, and gastric cancer. We discuss the current limitations of IP drug delivery and propose several potential areas of progress. Expert opinion: The potential of IP drug delivery is hampered by off-label use of drugs developed for systemic therapy. The efficacy of IP chemotherapy for PM depends on cancer type, disease extent, and mode of drug delivery. Results from ongoing randomized trials will allow to better delineate the potential of IP chemotherapy. Promising approaches include IP aerosol therapy, prolonged delivery platforms such as gels or biomaterials, and the use of nanomedicine.
Keywords
Peritoneal, intraperitoneal, metastasis, chemotherapy, mesothelial, CYTOREDUCTIVE SURGERY, RANDOMIZED-TRIAL, PSEUDOMYXOMA PERITONEI, SYSTEMIC CHEMOTHERAPY, COLORECTAL-CANCER, OVARIAN-CANCER, TISSUE TRANSPORT, ONCOLOGY-GROUP, DRUG-DELIVERY, COLON-CANCER

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MLA
Ceelen, Wim, et al. “Intraperitoneal Chemotherapy for Peritoneal Metastases : An Expert Opinion.” EXPERT OPINION ON DRUG DELIVERY, vol. 17, no. 4, 2020, pp. 511–22, doi:10.1080/17425247.2020.1736551.
APA
Ceelen, W., Braet, H., Van Ramshorst, G., Willaert, W., & Remaut, K. (2020). Intraperitoneal chemotherapy for peritoneal metastases : an expert opinion. EXPERT OPINION ON DRUG DELIVERY, 17(4), 511–522. https://doi.org/10.1080/17425247.2020.1736551
Chicago author-date
Ceelen, Wim, Helena Braet, Gabrielle Van Ramshorst, Wouter Willaert, and Katrien Remaut. 2020. “Intraperitoneal Chemotherapy for Peritoneal Metastases : An Expert Opinion.” EXPERT OPINION ON DRUG DELIVERY 17 (4): 511–22. https://doi.org/10.1080/17425247.2020.1736551.
Chicago author-date (all authors)
Ceelen, Wim, Helena Braet, Gabrielle Van Ramshorst, Wouter Willaert, and Katrien Remaut. 2020. “Intraperitoneal Chemotherapy for Peritoneal Metastases : An Expert Opinion.” EXPERT OPINION ON DRUG DELIVERY 17 (4): 511–522. doi:10.1080/17425247.2020.1736551.
Vancouver
1.
Ceelen W, Braet H, Van Ramshorst G, Willaert W, Remaut K. Intraperitoneal chemotherapy for peritoneal metastases : an expert opinion. EXPERT OPINION ON DRUG DELIVERY. 2020;17(4):511–22.
IEEE
[1]
W. Ceelen, H. Braet, G. Van Ramshorst, W. Willaert, and K. Remaut, “Intraperitoneal chemotherapy for peritoneal metastases : an expert opinion,” EXPERT OPINION ON DRUG DELIVERY, vol. 17, no. 4, pp. 511–522, 2020.
@article{8654248,
  abstract     = {Introduction: The rationale for intraperitoneal (IP) drug delivery for patients with peritoneal metastases (PM) is based on the pharmacokinetic advantage resulting from the peritoneal-plasma barrier, and on the potential to adequately treat small, poorly vascularized PM. Despite a history of more than three decades, many aspects of IP drug delivery remain poorly studied. Areas covered: We outline the anatomy and physiology of the peritoneal cavity, including the pharmacokinetics of IP drug delivery. We discuss transport mechanisms governing tissue penetration of IP chemotherapy, and how these are affected by the biomechanical properties of the tumor stroma. We provide an overview of the current clinical evidence on IP chemotherapy in ovarian, colorectal, and gastric cancer. We discuss the current limitations of IP drug delivery and propose several potential areas of progress. Expert opinion: The potential of IP drug delivery is hampered by off-label use of drugs developed for systemic therapy. The efficacy of IP chemotherapy for PM depends on cancer type, disease extent, and mode of drug delivery. Results from ongoing randomized trials will allow to better delineate the potential of IP chemotherapy. Promising approaches include IP aerosol therapy, prolonged delivery platforms such as gels or biomaterials, and the use of nanomedicine.},
  author       = {Ceelen, Wim and Braet, Helena and Van Ramshorst, Gabrielle and Willaert, Wouter and Remaut, Katrien},
  issn         = {1742-5247},
  journal      = {EXPERT OPINION ON DRUG DELIVERY},
  keywords     = {Peritoneal,intraperitoneal,metastasis,chemotherapy,mesothelial,CYTOREDUCTIVE SURGERY,RANDOMIZED-TRIAL,PSEUDOMYXOMA PERITONEI,SYSTEMIC CHEMOTHERAPY,COLORECTAL-CANCER,OVARIAN-CANCER,TISSUE TRANSPORT,ONCOLOGY-GROUP,DRUG-DELIVERY,COLON-CANCER},
  language     = {eng},
  number       = {4},
  pages        = {511--522},
  title        = {Intraperitoneal chemotherapy for peritoneal metastases : an expert opinion},
  url          = {http://dx.doi.org/10.1080/17425247.2020.1736551},
  volume       = {17},
  year         = {2020},
}

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