title: Activity of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) with cisplatin and doxorubicin in women with recurrent, platinum-resistant ovarian cancer: preliminary clinical experience.
abstract: OBJECTIVE
  To assess the activity of laparoscopic Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) in women with recurrent, platinum-resistant ovarian cancer.
  
  
  METHODS
  Prospective case series using repeated courses q 28-42 days of PIPAC containing cisplatin 7.5 mg/m(2) and doxorubicin 1.5 mg/m(2) at 12 mmHg and 37°C for 30 min. Objective tumor response was defined as tumor regression on histology and peritoneal carcinomatosis index (PCI) improvement on repeated video-laparoscopy.
  
  
  RESULTS
  34 PIPAC procedures were performed in 18 women, in 8 instances combined with cytoreductive surgery (CRS). Eight women had repeated PIPAC and objective tumor response was observed in 6 (complete remission: 1; partial remission: 2; stable disease: 3). Five adverse events WHO grade ≥ 2 were noted, 3 of them after combined CRS. No perioperative mortality occurred. Median follow-up was 192 days (min. 13-max. 639). Cumulative survival after 400 days was 62% and mean actuarial survival time was 442 days. In a multivariable regression analysis with objective tumor response (yes vs. no) as the dependent variable and PIPAC (1 vs.>1), patient age (<75 vs.≥75 years), serum CA-125 (<1000 vs.>1000 U/mL), and the presence of ascites (yes vs. no) as independent variables, PIPAC independently predicted objective tumor response.
  
  
  CONCLUSIONS
  PIPAC has activity in women with recurrent, platinum-resistant ovarian cancer and should be investigated in prospective clinical trials.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany. Electronic address: clemens.tempfer@marienhospital-herne.de.
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Celik
authors.affiliation: Department of Surgery, Ruhr University Bochum, Bochum, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Solass
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Buerkle
authors.affiliation: Department of Surgery, Ruhr University Bochum, Bochum, Germany.
authors.forename: Urs G
authors.initials: UG
authors.lastname: Pabst
authors.affiliation: Department of Surgery, Ruhr University Bochum, Bochum, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Zieren
authors.affiliation: Department of Hemato-Oncology, Ruhr University Bochum, Bochum, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Strumberg
authors.affiliation: Department of Surgery, Ruhr University Bochum, Bochum, Germany.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Reymond
mesh_terms: D000336:Aerosols / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D000077216:Carcinoma, Ovarian Epithelial; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D057176:Compassionate Use Trials; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000473:pathology; D011312:Pressure; D011446:Prospective Studies; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D000336:Aerosols; D004317:Doxorubicin; D002945:Cisplatin
keywords: Chemotherapy; High pressure; Intraabdominal; Platinum-resistant; Recurrent ovarian cancer