PIPAC therapy - very promising

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radnyc
Posts: 446
Joined: Tue Apr 06, 2010 6:32 pm

PIPAC therapy - very promising

Postby radnyc » Fri Jun 14, 2019 8:35 am

PIPAC for the Treatment of Colorectal Peritoneal Metastases

Particularly for those with peritoneal spread. Extremely unobtrusive and some good results in Europe.

Article:

https://www.onclive.com/onclive-tv/dr-l ... ac-in-mcrc

“PIPAC is a new way of delivering chemotherapy to the abdomen, Lee says. This approach is not used following surgery, Lee notes, so PIPAC can be used in conjunction with systemic chemotherapy. While PIPAC is more widely used in Europe and Asia, he adds. PIPAC allows him to better visualize the treatment because with each session, surgeons can gauge how the cancer is responding to therapy in real-time and it’s relatively safe due to the way that it’s delivered. Although there are benefits to both approaches, Lee thinks that PIPAC will become increasingly more prevalent. Many centers in the United States are interested in looking into this modality, he adds.”

There’s a clinical trial going on:

https://clinicaltrials.gov/ct2/show/NCT03868228
DX Jan 2010, at age 47
Feb - colon resection - 2/17 nodes positive
April - liver mets - Stage 4
3 months Folfox chemotherapy
August '10 liver resection and HAI pump
7 months chemo FUDR HAI and Folfiri systemic
NED since August 2010
Last treatment April 2011
HAI Pump removed Dec 2015

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: PIPAC therapy - very promising

Postby CRguy » Sat Jun 15, 2019 10:13 pm

bumping up here and surprised to see no replies so far

This is a novel technique with many possible applications. One of the earlier references I found was
Therapeutic options for peritoneal metastasis arising from colorectal cancer from 2016

I am certain we will hear more about this as it is already internationally available, and gaining interest in the US.
As you mentioned there are clinical trials utilizing this and this article expands on the comparison to HIPEC
HIPEC and PIPAC: comparison of an experimental duplex drug to standard drug regimens in vitro

Thanks for posting this
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

brokenwings
Posts: 147
Joined: Mon Jan 07, 2019 1:50 am

Re: PIPAC therapy - very promising

Postby brokenwings » Sun Jun 16, 2019 2:09 am

Very promising indeed.

It was created by professor Raymond in Germany, where it has been used since 2011. Later (2016), it came to France. It's available in Italy, Spain, Argentina, etc.

It's a good option for patients too frail for cyto-reductive surgery + HIPEC or for patients with a heavy burden of disease who aren't good candidates for HIPEC. PIPAC can lead some of those patients to resectability.

I'm currently undergoing a clinical trial to get to CRS+HIPEC with a different techinique (intraperitoneal chemotherapy).

All of these different methods of delivering chemotherapy to the peritoneum were born out of the difficulty to reach this part of the body (which is poorly vascularized and thus less blood -and less chemo- gets there).

Let's hope PIPAC and IP chemo help us overcome this type of mets.

Cheers.
DX 2019 Adenocarcinoma Sigmoid colon. PC + ovarian met.
Obstruction. Temporary colostomy.
Folfirinox + Avastin: 6 cycles. Scans: partial response.
Surgery (CRS + HIPEC) 04/29: too much disease, surgery cancelled. Right ovary removed.
2nd ptotocol: IP chemo (oxaliplatin) + IV chemo (Folfiri + Avastin). 8 cycles
10/31/2019: 11 hour-long Hipec + 6 weeks in hospital
12/30/2019: liver met
02/05/2020: reversal surgery. New peri mets discovered
March 2020: 5fu+Avastin
May 2020: fistula
Back to 1957: 5fu.


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