title: Dynamic changes of tumor gene expression during repeated pressurized intraperitoneal aerosol chemotherapy (PIPAC) in women with peritoneal cancer.
abstract: Intraperitoneal chemotherapy is used to treat peritoneal cancer. The pattern of gene expression changes of peritoneal cancer during intraperitoneal chemotherapy has not been studied before. Pressurized intraperitoneal aerosol chemotherapy is a new form of intraperitoneal chemotherapy using repeated applications and allowing repeated tumor sampling during chemotherapy. Here, we present the analysis of gene expression changes during pressurized intraperitoneal aerosol chemotherapy with doxorubicin and cisplatin using a 22-gene panel.
  
  
  
  Total RNA was extracted from 152 PC samples obtained from 63 patients in up to six cycles of intraperitoneal chemotherapy. Quantitative real-time PCR was used to determine the gene expression levels. For select genes, immunohistochemistry was used to verify gene expression changes observed on the transcript level on the protein level. Observed (changes in) expression levels were correlated with clinical outcomes.
  
  
  
  Gene expression profiles differed significantly between peritoneal cancer and non- peritoneal cancer samples and between ascites-producing and non ascites-producing peritoneal cancers. Changes of gene expression patterns during repeated intraperitoneal chemotherapy cycles were prognostic of overall survival, suggesting a molecular tumor response of peritoneal cancer. Specifically, downregulation of the whole gene panel during intraperitoneal chemotherapy was associated with better treatment response and survival.
  
  
  
  In summary, molecular changes of peritoneal cancer during pressurized intraperitoneal aerosol chemotherapy can be documented and may be used to refine individual treatment and prognostic estimations.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany. guenther.rezniczek@rub.de.|Marien Hospital Herne, Düngelstr. 33, 44623, Herne, Germany. guenther.rezniczek@rub.de.
authors.forename: Günther A
authors.initials: GA
authors.lastname: Rezniczek
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Jüngst
authors.affiliation: Department of Pathology, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Jütte
authors.affiliation: Department of Pathology, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tannapfel
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Hilal
authors.affiliation: Department of Obstetrics and Gynecology, Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Hefler
authors.affiliation: Department of Surgery, Ruhr-Universität Bochum, Bochum, Germany.|Present Address: Department of General, Gastrointestinal and Transplantation Surgery, University of Tübingen, Tübingen, Germany.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Reymond
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001201:Ascites / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods*; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects; D053263:Gene Regulatory Networks / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; Gene signature; PIPAC; Peritoneal cancer; Prognosis