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Intraperitoneal chemotherapy against peritoneal carcinomatosis: Current status and future perspective
Affiliation:1. Cancer Research Center, Sanford-Burnham Medical Research Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA;3. Center of Nanomedicine and Department of Cell, Molecular and Developmental Biology, 2203 Life Sciences Building, MCDB, University of California, Santa Barbara, CA 93106-9625, USA;4. Department of Surgical Oncology, The University of Tokyo, Bunkyo-ku, Tokyo, Japan;5. Department of Reproductive Medicine, Division of Gynecologic Oncology, Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0987, USA;6. Department of Medicine, Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0819, USA;7. Institute of Biomedicine and Translational Medicine, Centre of Excellence for Translational Medicine, University of Tartu, Ravila 14b, Tartu 50411, Estonia;8. Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0987, USA
Abstract:
Peritoneal carcinomatosis (PC), caused by advanced abdominal malignancies, such as those of the ovarian and gastrointestinal tracts, has an extremely poor prognosis. Intraperitoneal (IP) chemotherapy has been clinically applied for several decades, but its clinical efficacy has not been fully determined. An accumulating body of evidence suggests that cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is the optimal treatment for selected patients with ovarian and colorectal cancers with PC. Recent studies suggest that IP administration of taxane with systemic chemotherapy in a neoadjuvant setting improves patient survival in gastric cancer with PC. The pharmacokinetics of IP-administered drugs should be primarily considered in order to optimize IP chemotherapy. Therefore, the development of specific IP drugs using newly emerging molecular targeted reagents or new drug delivery systems, such as nanomedicine or controlled absorption/release methods, is essential to improve the efficacy of IP chemotherapy.
Keywords:Gastric cancer  Colorectal cancer  Intraperitoneal chemotherapy  Peritoneal carcinomatosis  Pharmacokinetics
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