title: Pharmacokinetics of pegylated liposomal doxorubicin administered by intraoperative hyperthermic intraperitoneal chemotherapy to patients with advanced ovarian cancer and peritoneal carcinomatosis.
abstract: The pharmacokinetics of pegylated liposomal doxorubicin (PLD) were investigated in 17 women undergoing intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced ovarian cancer and peritoneal carcinomatosis. HIPEC was performed immediately after completing debulking surgery, which included a number of peritonectomy procedures. PLD was injected and allowed to equilibrate in peritoneal cavity filled with 4 liters of physiological solution and stabilized at 42°C; next, the outflow line was opened and perfusion proceeded for 1 h. PLD was stable in peritoneal perfusate and plasma. During HIPEC, PLD peritoneal perfusate/plasma gradients averaged ∼600 or ≥1000 for peak concentration or area under the curve. After HIPEC, PLD plasma levels remained stable or decreased. Biopsy samples of residual normal peritoneum or ovarian carcinomatosis were collected at the end of HIPEC and were shown to contain free doxorubicin. Correlating PLD decrements in peritoneal perfusate with plasma exposure to PLD or peritoneal deposition of free doxorubicin showed that the former occurred during preperfusional equilibration of PLD in peritoneal cavity, whereas the latter occurred during 1 h of perfusion. Plasma exposure to PLD correlated negatively with the number of peritonectomy procedures performed during surgery, whereas peritoneal deposition of free doxorubicin correlated positively. Taken together, these results show that PLD administered by intraoperative HIPEC undergoes limited systemic diffusion and releases active free doxorubicin in peritoneum exposed to ovarian carcinomatosis. PLD pharmacokinetics seem to be influenced by peritonectomy procedures.
authors.affiliation: CIR and Drug Sciences, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Salvatorelli
authors.forename: Michele
authors.initials: M
authors.lastname: De Tursi
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Menna
authors.forename: Consiglia
authors.initials: C
authors.lastname: Carella
authors.forename: Renato
authors.initials: R
authors.lastname: Massari
authors.forename: Antonella
authors.initials: A
authors.lastname: Colasante
authors.forename: Stefano
authors.initials: S
authors.lastname: Iacobelli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Minotti
mesh_terms: D000368:Aged; D019540:Area Under Curve; D002277:Carcinoma / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D010537:Peritoneum / Q000378:metabolism / Q000601:surgery; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000493:pharmacokinetics*
chemical_list: C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin