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. 2023 Sep 11;8(4):157-165.
doi: 10.1515/pp-2023-0008. eCollection 2023 Dec.

UK trial of pressurised intraperitoneal aerosolised chemotherapy (PIPAC) with oxaliplatin for colorectal cancer peritoneal metastases (NCT03868228)

Peter Kyle  1 , Kitrick Perry  2 , Anne Moutadjer  2 , Nicholas Gilfillan  2 , Rosalind Webb  2 , Dolan Basak  2 , Paul Ziprin  1 , Dominic Blunt  2 , James Burn  2 , Katherine Van Ree  2 , Antoni Sergot  2 , Jamie Murphy  3
Affiliations

UK trial of pressurised intraperitoneal aerosolised chemotherapy (PIPAC) with oxaliplatin for colorectal cancer peritoneal metastases (NCT03868228)

Peter Kyle et al. Pleura Peritoneum. .

Abstract

Objectives: This is the first UK trial of pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for colorectal cancer peritoneal metastases. This trial aimed to assess the impact of PIPAC in combination with standard of care systemic treatment on: progression free survival (PFS); quality of life (QoL); and short-term complications. In addition, this trial set out to demonstrate that PIPAC can be performed safely in operating theatres within a National Health Service (NHS) setting.

Methods: Single-centre clinical trial with prospective data collection for patients undergoing 8-weekly PIPAC with oxaliplatin at 92 mg/m2 from January 2019 till January 2022. Progression free survival was assessed using peritoneal carcinomatosis index (PCI) by CT scans and laparoscopy. Quality of life was assessed by EORTC QLQ-C30 questionnaire. Adverse events were recorded using CTCAE.

Results: Five patients underwent a total of ten PIPAC administrations (median 2, range 1-4). Median PFS was 6.0 months. QoL was maintained across repeat PIPAC procedures but a decrease in social functioning and increased fatigue were evident. Three incidences of grade 3 adverse events occurred but PIPAC was well tolerated.

Conclusions: The presented data demonstrates that PIPAC is feasible and can be safely delivered within the NHS for patients with colorectal cancer peritoneal metastases, but caution must also be exercised given a risk of adverse events. Systemic chemotherapy can be safely administered at a different unit to the PIPAC procedure if both groups have clear lines of communication and timely data sharing.

Keywords: colorectal cancer; peritoneal metastases; pipac; pressurised intraperitoneal aerosolised chemotherapy.

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Conflict of interest statement

Competing interests: Authors state no conflict of interest.

Figures

Figure 1:
Figure 1:
Trial protocol flowchart.
Figure 2:
Figure 2:
Selected domains from EORTC QLQ-C30 results.
Figure 3:
Figure 3:
Heatmap of location and volume score of peritoneal metastases across multiple PIPAC administrations.
See this image and copyright information in PMC

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